A nurse is preparing to administer clindamycin to a client who states she forgot to report to the provider that she is allergic to penicillin. Which of the following actions should the nurse take?

Choice A Reason:
Weight gain of 0.7 kg (1.5 lb) in 24 hours is not recommendable. While sudden weight gain can indicate fluid retention, it is not a direct contraindication for administering digoxin. However, it might indicate worsening heart failure, which needs attention, but it doesn't specifically necessitate withholding digoxin.
Choice B Reason:
Urinary output 30 mL/hr is not recommendable. A low urinary output might indicate decreased kidney perfusion or renal issues. While monitoring urinary output is important, it is not a direct reason to withhold digoxin unless it's coupled with severe renal impairment or an acute kidney injury.
For a client receiving digoxin, certain findings would warrant withholding the medication due to potential complications. Among the options provided:
Choice C Reason:
Pulse rate 56/min is the correct recommendation. A low pulse rate (bradycardia), especially below 60 beats per minute, is a reason to withhold digoxin. Digoxin can further decrease the heart rate, potentially leading to excessive bradycardia or heart block. The nurse should hold the medication and consult with the healthcare provider to determine the appropriate action.
Choice D Reason:
BP 160/90 mm Hg is not recommendable. Elevated blood pressure alone is not a direct contraindication for administering digoxin to a patient with heart failure. Digoxin is not primarily used for controlling blood pressure; its use is more focused on managing heart rate and contractility in heart failure patients.

Choice A Reason:
"You should monitor for hearing difficulties." is correct. Loop diuretics like bumetanide can occasionally cause ototoxicity, resulting in hearing difficulties or ringing in the ears (tinnitus) as a potential adverse effect. It's important for clients taking these medications to be aware of such symptoms and report them promptly to their healthcare provider.
Choice B Reason:
"You should take the medication at bedtime." Is incorrect. Bumetanide is commonly prescribed to be taken in the morning to avoid nighttime diuresis and potential sleep disruption due to increased urination.
Choice C Reason:
"You should decrease your intake of foods high in potassium." Is incorrect. Loop diuretics often lead to potassium loss, so clients may actually need to increase their intake of potassium-rich foods or take potassium supplements under healthcare provider guidance to maintain normal potassium levels.
Choice D Reason:
"You should take this medication on an empty stomach." Is incorrect. Bumetanide can be taken with or without food, so it's not necessary to take it on an empty stomach.