A nurse is assessing an adult client who is receiving morphine via continuous IV infusion. The nurse should identify that which of the following is the priority finding?

A) Increase in bowel function: Propofol is a sedative-hypnotic agent commonly used for induction and maintenance of anesthesia and sedation for procedures such as colonoscopies. While propofol may affect gastrointestinal motility, it typically leads to a decrease rather than an increase in bowel function. Therefore, an increase in bowel function would not be an expected adverse effect of propofol administration.

B) Increase in heart rate: Propofol generally has a depressant effect on the cardiovascular system, leading to a decrease rather than an increase in heart rate. It causes vasodilation and can result in hypotension and bradycardia, especially during induction of anesthesia. Therefore, an increase in heart rate would not be an expected adverse effect of propofol administration.

C) Decrease in respiratory rate: Respiratory depression is a well-known adverse effect of propofol. It acts as a potent central nervous system depressant, leading to dose-dependent respiratory depression. This effect is more pronounced when propofol is used for deeper levels of sedation or anesthesia. Therefore, monitoring for a decrease in respiratory rate is essential during and after propofol administration to prevent hypoxemia and respiratory compromise.

D) Decrease in body temperature: Propofol infusion syndrome (PRIS) is a rare but potentially fatal complication associated with prolonged high-dose propofol administration. Among its manifestations are metabolic acidosis, rhabdomyolysis, hyperlipidemia, and ultimately, multi-organ failure. However, a decrease in body temperature is not a characteristic feature of PRIS. Instead, hyperthermia or an increase in body temperature may occur as part of the syndrome. Therefore, monitoring for a decrease in body temperature is not a typical adverse effect of propofol administration.

A) "Inject the medication into the lateral thigh": While the lateral thigh is a common site for subcutaneous injections, enoxaparin is typically administered in the abdomen. Instructing the client to inject into the lateral thigh may lead to incorrect administration. Therefore, this instruction is not appropriate for enoxaparin administration.

B) "Ensure that the air bubble remains in the syringe": This instruction is correct. Enoxaparin prefilled syringes usually come with an air bubble to help ensure the full dose is delivered. Instructing the client to keep the air bubble in the syringe helps prevent the loss of medication during administration, ensuring that the full dose is delivered subcutaneously.

C) "Release the skin fold before injecting the medication": Releasing the skin fold before injecting the medication helps ensure proper needle insertion into the subcutaneous tissue and facilitates medication absorption. This instruction is generally appropriate for subcutaneous injections but is not specific to enoxaparin administration.

D) "Rub the site after injecting the medication": Rubbing the injection site after administration is not recommended, as it can cause irritation and discomfort. Instead, instruct the client to gently press on the injection site without rubbing to help disperse the medication and minimize bruising or discomfort. Therefore, this instruction is not appropriate for enoxaparin administration.