A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis?

Choice A reason: Reducing intake of potassium-rich foods is not necessary for clients taking hydrochlorothiazide, as this medication can cause hypokalemia (low potassium levels) due to increased potassium excretion in the urine. Clients may need to increase their intake of potassium-rich foods or take potassium supplements to prevent hypokalemia.

Choice B reason: Avoiding grapefruit juice is not necessary for clients taking hydrochlorothiazide, as this medication does not interact with grapefruit juice. Grapefruit juice can affect the metabolism of some other medications, such as statins, calcium channel blockers, and cyclosporine, by inhibiting the enzyme CYP3A4 in the liver.

Choice C reason: Taking this medication before bedtime is not advisable for clients taking hydrochlorothiazide, as this medication can cause increased urination and nocturia (nighttime urination). Clients should take this medication in the morning or at least 6 hours before bedtime to avoid disrupting their sleep.

Choice D reason: Monitoring for leg cramps is an important instruction for clients taking hydrochlorothiazide, as this medication can cause muscle cramps due to electrolyte imbalances, such as hypokalemia, hyponatremia (low sodium levels), or hypomagnesemia (low magnesium levels). Clients should report any signs of muscle cramps, weakness, or fatigue to their provider.

Choice A reason: A headache is not likely due to the anxiety about the chest pain, as anxiety usually causes other symptoms, such as palpitations, sweating, or trembling. A headache is more likely related to the vasodilating action of nitroglycerin, which causes increased blood flow to the brain.

Choice B reason: A headache does not indicate tolerance to the medication, as tolerance usually manifests as a reduced effect of the medication on relieving chest pain. A headache is more likely a sign of the medication's potency, as it indicates that the nitroglycerin is reaching the systemic circulation.

Choice C reason: A headache is an expected adverse effect of the medication, as nitroglycerin causes vasodilation of the cerebral vessels, which can result in increased intracranial pressure and pain. A headache is usually mild and transient, and can be relieved by taking analgesics, such as acetaminophen.

Choice D reason: A headache is not an indication of an allergy to the medication, as an allergic reaction usually causes other symptoms, such as rash, itching, swelling, or difficulty breathing. A headache is more likely a pharmacological effect of the medication, rather than an immunological response.