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: Giving the medication in the morning daily is a correct instruction, as it helps to prevent asthma attacks throughout the day and night. Montelukast is a leukotriene receptor antagonist that blocks the inflammatory response and bronchoconstriction caused by leukotrienes. Montelukast has a long duration of action and can be given once a day, preferably in the evening or at bedtime. However, for children who have exercise-induced asthma, the medication can be given in the morning to prevent exercise-induced bronchospasm.

Choice B reason: Administering the granules mixed with 20 oz of water is not a correct instruction, as it may reduce the absorption and effectiveness of the medication. Montelukast granules should be administered within 15 minutes of opening the packet and can be mixed with a small amount of soft food, such as applesauce, mashed carrots, or ice cream. The granules should not be mixed with liquids, such as water, juice, or milk, as they may dissolve and lose their potency.

Choice C reason: Giving the medication at the onset of wheezing is not a correct instruction, as it may not provide immediate relief of the symptoms and may delay the use of a rescue inhaler. Montelukast is not a bronchodilator and does not work quickly to open the airways. Montelukast is a preventive medication that should be taken regularly to reduce the frequency and severity of asthma attacks. The child should use a short-acting beta-agonist, such as albuterol, for the quick relief of wheezing.

Choice D reason: Administering the medication 2 hr before exercise is not a correct instruction, as it may not prevent exercise-induced bronchospasm and may interfere with the daily dosing schedule. Montelukast should be taken once a day, preferably in the evening or at bedtime, to provide consistent protection against asthma triggers. However, for children who have exercise-induced asthma, the medication can be given in the morning to prevent exercise-induced bronchospasm. The child should also use a short-acting beta-agonist before exercise, as needed.

Choice A reason: Ataxia is not a manifestation of digoxin toxicity, as it does not affect the coordination or balance of the client. Ataxia may be caused by other factors, such as cerebellar disorders, alcohol intoxication, or medication interactions.

Choice B reason: Anorexia is a manifestation of digoxin toxicity, as it affects the appetite and digestion of the client. Anorexia may be accompanied by nausea, vomiting, or abdominal pain, which are also signs of digoxin toxicity. Anorexia may lead to weight loss, dehydration, or electrolyte imbalance, which can worsen the condition of the client.

Choice C reason: Photosensitivity is not a manifestation of digoxin toxicity, as it does not affect the skin or the eyes of the client. Photosensitivity may be caused by other factors, such as sun exposure, allergies, or medication interactions.

Choice D reason: Jaundice is not a manifestation of digoxin toxicity, as it does not affect the liver or the bilirubin level of the client. Jaundice may be caused by other factors, such as liver disease, gallstones, or hemolysis.