A client with plaque psoriasis receives a new prescription for betamethasone valerate lotion. Which instruction should the nurse include in client teaching?

A) Worsening headache:
This option is correct. Vasopressin, also known as antidiuretic hormone (ADH), acts to increase water reabsorption in the kidneys, thereby reducing urine output. However, excessive administration of vasopressin can lead to vasoconstriction, which may result in increased intracranial pressure and subsequent headaches. Therefore, worsening headache can be indicative of vasopressin overdose or adverse effects, and it should be promptly reported to the healthcare provider for evaluation and appropriate management.

B) Polyuria:
Polyuria, or excessive urine output, is the opposite effect of vasopressin. While diabetes insipidus is characterized by polyuria due to insufficient ADH secretion or renal responsiveness to ADH, administering vasopressin should decrease urine output. Therefore, polyuria would not be expected as a side effect of vasopressin administration.

C) Polydipsia:
Polydipsia, or excessive thirst, is also a symptom of diabetes insipidus but is not typically associated with vasopressin administration. Vasopressin functions to decrease urine output and, consequently, reduce thirst. Therefore, polydipsia would not be expected as a side effect of vasopressin administration.

D) Low urine specific gravity:
Vasopressin administration is expected to increase urine specific gravity by promoting water reabsorption in the kidneys, leading to more concentrated urine. Therefore, low urine specific gravity would not be an expected side effect of vasopressin administration.

A)Holds the pen in place after the injection:
This action is appropriate. Holding the auto-injector pen in place after administering the injection allows the medication to be fully delivered into the muscle. It ensures that the full dose of epinephrine is administered, which is crucial during an emergency situation such as anaphylaxis.

B) Administers into the fleshy outer thigh:
Administering the epinephrine injection into the fleshy outer thigh is the correct technique. The thigh muscle provides a large and accessible area for injection, allowing for rapid absorption of the medication into the bloodstream. This action facilitates the quick onset of epinephrine’s effects, which is vital in treating anaphylaxis.

C) Cleanses the injection pen for re-use:
This action requires intervention by the nurse. Epinephrine auto-injectors are designed for single use only and should not be cleansed or reused. Reusing the injection pen can lead to contamination, incorrect dosing, or malfunction, compromising its effectiveness during subsequent emergencies. It is essential to educate the client that the auto-injector pen is for one-time use only, and a new device should be used if another dose is required.

D) Inserts the injection pen through clothing:
While it is ideal to administer the injection directly onto bare skin, inserting the injection pen through clothing is acceptable in emergency situations when immediate access to bare skin is not possible. The priority during anaphylaxis is administering the epinephrine promptly. However, if feasible, the clothing should be moved aside to allow direct contact of the injection site with the skin for optimal absorption of the medication.