A nurse is administering spironolactone at 0800 to a client who has heart failure.
The nurse should monitor the client for which of the following adverse effects?

Choice A rationale:

Oxycodone overdose typically results in constricted (not dilated) pupils due to its action on the central nervous system.

Choice B rationale:

Oxycodone overdose can cause respiratory depression, leading to slow and shallow breathing (bradypnea), not rapid breathing (tachypnea)

Choice C rationale:

Oxycodone does not typically cause tachycardia. It can cause bradycardia due to its action on the central nervous system.

Choice D rationale:

Sedation is a common effect of oxycodone and can be more pronounced in cases of overdose due to the drug’s depressant effect on the central nervous system.

Choice A rationale:

Checking blood pressure with the client standing could exacerbate the client’s symptoms due to orthostatic hypotension, which is a common side effect of captopril.

Choice B rationale:

Administering a 0.9% sodium chloride IV bolus could be considered if the client’s blood pressure does not improve with positioning changes or if the client’s condition worsens.

Choice C rationale:

Placing the client in a supine position can help increase blood flow to the brain and alleviate symptoms of low blood pressure. This should be the first action taken by the nurse.

Choice D rationale:

Measuring blood pressure with the client sitting could also exacerbate symptoms due to orthostatic hypotension. It would be more appropriate after the client’s condition has stabilized.