Choice A rationale

Sildenafil, commonly known as Viagra, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. One of the side effects of sildenafil is visual changes. These changes can be temporary or long-lasting, and can potentially be a sign of a serious condition known as non-arteritic anterior ischemic optic neuropathy (NAION), which can lead to permanent vision loss. Therefore, it is crucial for the client to report these symptoms to the healthcare provider immediately for further evaluation and management.

Choice B rationale

While eye drops can be used to treat various eye conditions, they are not typically used to address visual changes caused by sildenafil. Therefore, instilling prescribed eye drops would not be the appropriate response in this situation.

Choice C rationale

Wearing dark glasses when outside can help protect the eyes from sun damage, but it would not address the underlying issue of visual changes caused by sildenafil. Therefore, this would not be the appropriate instruction for the practical nurse to give to the client.

Choice D rationale

The Amsler grid tool is used to detect vision problems resulting from damage to the macula (the central part of the retina) or the optic nerve. However, this tool would not be useful in this context as the visual changes are a side effect of sildenafil. Therefore, monitoring for visual changes each morning using an Amsler grid tool would not be the appropriate instruction for the practical nurse to give to the client.

Choice A rationale

Involuntary movements of the lips and tongue are typically associated with antipsychotic medications, not nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac15. Therefore, observing the client for these symptoms would not be a relevant intervention for a client taking ketorolac15.

Choice B rationale

Administering the medication at least 30 minutes before meals is not a specific requirement for ketorolac15. Therefore, this would not be a necessary intervention for a client taking this medication15.

Choice C rationale

Ketorolac, like other NSAIDs, can increase the risk of bleeding15. This can manifest as areas of ecchymosis (bruising) or other signs of bleeding on the skin15. Therefore, assessing the skin daily for these signs would be an important intervention for a client taking ketorolac15.

Choice D rationale

Peak and trough serum levels are typically monitored for medications with a narrow therapeutic index, such as certain antibiotics15. Ketorolac does not typically require

monitoring of serum levels15. Therefore, ensuring peak and trough serum levels are collected would not be a necessary intervention for a client taking this medication15.