A nurse is caring for a client in the intensive care unit.

Exhibits

The nurse is reviewing the admission assessment, nurses' notes, vital signs, and laboratory results. Drag words from the choices below to fill in each blank in the following sentence. The nurse identifies that the client's and can indicate the development of delirium.

A.

A. "Notify your provider if you experience muscle weakness." - Muscle weakness can be a sign of digoxin toxicity and should be reported to the provider immediately.

B. "Report a weight gain of one-half pound per day." - While weight gain can indicate fluid retention, it is not a specific symptom of digoxin toxicity.

C. "Expect this medication to increase your blood pressure." - Digoxin is not typically associated with increasing blood pressure.

D. "You will need to take a diuretic while taking this medication." - Diuretics are not typically required with digoxin unless there are specific indications for their use.

A.

A. It's important to include the complete name of the medication to ensure clarity and accuracy in documentation.

B. Omitting the leading zero before a decimal point can lead to medication errors, so it's important to include it.

C. "U" is commonly used to denote units when documenting insulin dosage, so this statement is accurate.

D. "QOD" is an outdated abbreviation and can lead to confusion, so it should not be used; instead, "every other day" should be written out for clarity.