A nurse is applying a nitroglycerin transdermal patch for a client who has angina. Which of the following actions should the nurse take?

Choice A Reason:
Weight gain is incorrect. Weight gain is typically associated with fluid volume excess rather than deficit. In heart failure, fluid retention can lead to weight gain due to excess fluid accumulation in the body.
Choice B Reason:
Distended neck veins is incorrect. Distended neck veins are a sign of fluid volume excess, commonly seen in heart failure due to increased venous pressure and fluid retention.
Choice C Reason:
Shortness of breath is incorrect.: Shortness of breath is often associated with fluid accumulation in the lungs, known as pulmonary edema, which is a manifestation of fluid volume excess or fluid overload in heart failure.
Choice D Reason:
Elevated hematocrit level is correct. Furosemide is a diuretic that promotes diuresis (increased urine output), leading to fluid loss. When a client experiences fluid volume deficit or dehydration due to increased diuresis, there is a concentration of red blood cells in the blood, resulting in an elevated hematocrit level. This occurs because the blood becomes more concentrated when there's less fluid volume available.

Choice A Reason:
Tinnitus, a perception of noise or ringing in the ears, is not typically associated with paroxetine use.
Choice B Reason:
Drowsiness or somnolence is a common adverse effect associated with paroxetine and many other selective serotonin reuptake inhibitors (SSRIs). It's crucial for clients to be aware of this potential side effect, especially when starting the medication or adjusting the dosage. It might affect their ability to perform tasks requiring alertness, such as driving or operating machinery.
Choice C Reason:
Peripheral edema, or swelling in the extremities, is not a common adverse effect linked specifically to paroxetine use.
Choice D Reason:
Alopecia is correct. Alopecia, or hair loss, is not a commonly reported adverse effect of paroxetine.