A nurse is preparing to administer a medication to a client for the first time and needs to know about potential food and medication interactions. Which of the following actions should the nurse take?

A) Instruct the ’lient that their central line dressing must be changed every 24 hr: While it's essential to maintain proper hygiene a’d care for a central line to prevent infection, changing the dressing every 24 hours may not be necessary. The frequency of dressing changes depends on institutional policies and the client's condition. Providing accurate informat’on about dressing changes based on specific guidelines is important for the client's safety and the prevention of central l’ne-related infections.

B) Instruct the client to weigh themselves daily and record their weight: This is the correct instruction. Monitoring daily weight allows for the assessment of fluid status and the effectiveness of TPN therapy. Weight gain or loss can indicate fluid retention or depletion, respectively, which may necessitate adjustments to the TPN prescription. Recording daily weights provides valuable data for healthcare providers to evaluate the client's response to TPN and make appropriate m’difications to the treatment plan.

C) Instruct the client that one container of TPN may infuse for up to 72 hr: The duration of TPN administration varies depending on factors such as the client's nutritional needs, medical condition, ’nd the stability of the TPN solution. While some TPN solutions may be stable for up to 24-48 hours, infusing for 72 hours could increase the risk of contamination and compromise the integrity of the solution, leading to adverse effects. Providing accurate information about the duration of TPN infusion based on the specific prescription ensures the client's safety and the efficacy of therapy.

D’ Instruct the client to speed up the rate of their TPN infusion if it falls behind schedule: Altering the rate of TPN infusion without healthcare provider guidance can lead to complications such as hyperglycemia, electrolyte imbalances, or fluid overload. TPN infusion rates are carefully prescribed based on the client's nutritional needs and metabolic status’ If the infusion falls behind schedule, it's essential for the client to contact th’ir healthcare provider for guidance on adjusting the infusion rate or managing any potential issues.

A) Digoxin and levothyroxine: Digoxin is a cardiac glycoside used to treat heart failure and atrial fibrillation, while levothyroxine is a thyroid hormone replacement medication used to treat hypothyroidism. While both medications have potential side effects, hearing loss is not typically associated with either digoxin or levothyroxine. Therefore, monitoring for hearing loss related to a medication interaction is not a priority for clients taking digoxin and levothyroxine.

B) Losartan and atorvastatin: Losartan is an angiotensin II receptor blocker used to treat hypertension, while atorvastatin is a statin medication used to lower cholesterol levels. Hearing loss is not a known side effect of either losartan or atorvastatin, nor is there evidence of an interaction between these medications that would increase the risk of hearing loss. Therefore, monitoring for hearing loss related to a medication interaction is not indicated for clients taking losartan and atorvastatin.

C) Propranolol and raloxifene: Propranolol is a beta-blocker used to treat hypertension, angina, and other cardiovascular conditions, while raloxifene is a selective estrogen receptor modulator used to prevent and treat osteoporosis in postmenopausal women. Neither propranolol nor raloxifene is associated with hearing loss as a common side effect. Additionally, there is no known interaction between propranolol and raloxifene that would increase the risk of hearing loss. Therefore, monitoring for hearing loss related to a medication interaction is not necessary for clients taking propranolol and raloxifene.

D) Furosemide and amikacin: Furosemide is a loop diuretic that is commonly used to treat fluid overload conditions such as heart failure and edema. Amikacin is an aminoglycoside antibiotic used to treat bacterial infections. Both furosemide and amikacin have the potential to cause ototoxicity, which can manifest as hearing loss or tinnitus. When administered concurrently, especially at higher doses or for prolonged durations, the risk of ototoxicity may increase due to additive or synergistic effects on the inner ear structures. Therefore, the nurse should monitor clients receiving both furosemide and amikacin for signs of hearing loss, such as changes in hearing acuity or tinnitus, and promptly report any concerns to the healthcare provider for further evaluation and management.