A nurse is collecting data from a client who has hypertension.
The nurse should recognize that which of the following over-the-counter medications is contraindicated for this client?

Choice A rationale:

An apical pulse of 54/min is below the normal range for adults. Digoxin, a cardiac medication, can lower the heart rate. Therefore, it’s crucial to hold the medication if the resting pulse for an adult is less than 60 bpm. This is to prevent further lowering of the heart rate which could lead to bradycardia, a potentially dangerous condition.

Choice B rationale:

A respiratory rate of 14/min is within the normal adult range of 12-20 breaths per minute. This would not be a reason to withhold digoxin.

Choice C rationale:

A blood pressure (BP) of 179/89 mm Hg indicates hypertension, which is not a direct contraindication for digoxin. However, it’s important to monitor BP levels in clients taking digoxin as the medication can affect blood pressure.

Choice D rationale:

A temperature of 37.8° C (100° F) is slightly elevated but would not be a reason to withhold digoxin unless it’s indicative of an underlying infection that needs to be addressed first.

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.