A nurse is caring for a client who started taking amitriptyline 6 days ago.
The client reports that the medication is not helping.
Which of the following responses should the nurse make?

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.

Choice A rationale:

Mixing insulin lispro and insulin glargine in the same syringe is not recommended. Insulin glargine has a different pH and mixing it with other insulins could affect its action.

Choice B rationale:

Insulin glargine is a long-acting insulin that is typically given once a day. It provides a steady level of insulin over a 24-hour period.

Choice C rationale:

Shaking insulin vials is not recommended as it can lead to inaccurate dosing. Instead, insulin vials should be gently rolled between the hands to ensure proper mixing.

Choice D rationale:

Insulin lispro is a rapid-acting insulin and should be taken right before a meal. This helps to control the blood glucose spike that occurs after eating.