A nurse is reviewing home medications with a client scheduled for a cataract extraction procedure. Which of the following medications should the nurse question administering?

A. The client develops bradycardia and bradypnea: Bradycardia (slow heart rate) and bradypnea (slow breathing rate) may indicate a slowing down of bodily functions but are not typical manifestations of postoperative shock. In postoperative shock, the body's compensatory mechanisms often lead to tachycardia (rapid heart rate) and tachypnea (rapid breathing rate) as the body tries to maintain perfusion.

B. The client has metabolic alkalosis and warm extremities: Metabolic alkalosis and warm extremities are not typically associated with postoperative shock. In shock, metabolic acidosis is more common due to tissue hypoperfusion, and extremities may become cool due to peripheral vasoconstriction as the body attempts to shunt blood to vital organs.

C. The client has hypertension and anuria: Hypertension (high blood pressure) and anuria (lack of urine output) are not indicative of postoperative shock. In shock, blood pressure typically decreases (hypotension), and oliguria or anuria may occur due to decreased renal perfusion.

D. The client has hypotension and is confused: This is the correct answer. Hypotension (low blood pressure) is a hallmark sign of shock, indicating inadequate tissue perfusion. Confusion may occur due to cerebral hypoperfusion and inadequate oxygen delivery to the brain. Confusion is a late sign of shock and indicates severe compromise of organ perfusion.

A. Pericardiocentesis: Pericardiocentesis is a procedure used to drain fluid from the pericardial sac, typically performed in cases of pericardial effusion or cardiac tamponade. It is not indicated for the treatment of hypertrophic cardiomyopathy (HCM), which involves structural abnormalities of the heart muscle rather than pericardial fluid accumulation.

B. Septal myectomy: Septal myectomy is a surgical procedure performed to treat hypertrophic obstructive cardiomyopathy (HOCM), a subtype of hypertrophic cardiomyopathy characterized by thickening of the interventricular septum and dynamic left ventricular outflow tract obstruction. Septal myectomy involves the surgical removal of a portion of the hypertrophied septum to relieve left ventricular outflow tract obstruction and improve symptoms.

C. Pericardial window: A pericardial window is a surgical procedure used to create a communication between the pericardial sac and the pleural space, typically performed in cases of recurrent pericardial effusion or tamponade to prevent fluid re-accumulation. It is not indicated for the treatment of hypertrophic cardiomyopathy.

D. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to restore normal sinus rhythm in patients with certain types of cardiac arrhythmias, such as atrial fibrillation or atrial flutter. It is not typically indicated for the treatment of hypertrophic cardiomyopathy, although patients with HCM may develop arrhythmias as a complication.