A nurse is assessing a clie”t prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication?

A) Milk:
Milk is not known to interact significantly with verapamil. Therefore, there's no need for the client to avoid consuming milk while taking this medication.

B) Orange juice:
Orange juice does not typically interact with verapamil. However, calcium-containing foods and beverages, including orange juice, may reduce the absorption of verapamil when taken simultaneously. While the interaction is not severe, it's advisable for clients to separate the administration of verapamil from calcium-rich foods and beverages to optimize absorption.

C) Grapefruit juice:
This is the correct answer. Grapefruit juice contains compounds that inhibit the activity of cytochrome P450 enzymes, particularly CYP3A4, which are involved in the metabolism of many medications, including verapamil. Consuming grapefruit juice while taking verapamil can lead to elevated blood levels of the medication, increasing the risk of side effects and toxicity. Therefore, clients should avoid grapefruit juice while on verapamil therapy.

D) Coffee:
Coffee does not typically interact with verapamil. However, caffeine-containing beverages like coffee may exacerbate certain side effects of verapamil, such as dizziness or palpitations, due to their stimulant effects. Clients may be advised to limit caffeine intake or consume coffee in moderation while taking verapamil.

A) Routinely exercise indoors:
Exercising indoors may be beneficial for individuals taking anticholinergic drugs to minimize the risk of heat-related complications. However, this option does not directly address the need to avoid extremes of temperature on exertion, which is crucial for preventing heat exhaustion and heat stroke. While indoor exercise can provide a controlled environment, it does not eliminate the risk entirely, especially if the indoor area is not adequately ventilated or air-conditioned.

B) Wear dark, warm clothing during the summer months:
Wearing dark, warm clothing during the summer months can exacerbate the risk of heat-related complications for individuals taking anticholinergic drugs. Dark clothing absorbs more heat from the sun, increasing body temperature, and warm clothing further contributes to heat retention. This option does not align with the goal of minimizing the risk of heat exhaustion and heat stroke.

C) Avoid extremes of temperature on exertion:
This is the correct answer. Avoiding extremes of temperature on exertion is essential for individuals taking anticholinergic drugs to reduce the risk of heat-related complications such as heat exhaustion and heat stroke. Exertion in hot environments can lead to excessive sweating and dehydration, further compromising thermoregulation. By avoiding extremes of temperature and moderating exertion, individuals can better regulate body temperature and minimize the risk of heat-related adverse effects.

D) Take frequent showers in the evenings and early mornings:
While taking frequent showers in the evenings and early mornings may help cool the body and reduce the risk of heat-related discomfort, it does not specifically address the need to avoid extremes of temperature on exertion. While personal hygiene practices are important, they should be supplemented with measures aimed at preventing heat-related complications, such as avoiding exertion in extreme temperatures. Therefore, this option does not fully meet the goal of minimizing the risk of heat exhaustion and heat stroke for individuals taking anticholinergic drugs.