A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?

Choice A Reason:
"Limit your sodium intake." Is incorrect. Sodium restriction might be appropriate for some cardiovascular or renal conditions, but it is not specifically related to theophylline use.
Choice B Reason:
"Restrict milk products." is incorrect. Restricting milk products is not a necessary dietary consideration for theophylline. However, consuming high-fat dairy products may delay the absorption of theophylline, potentially affecting its effectiveness.
Choice C Reason:
"Avoid caffeinated beverages." Is correct. Theophylline is a bronchodilator used to treat respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD). It belongs to the class of methylxanthine medications and acts similarly to caffeine. Consuming additional caffeine through beverages like coffee, tea, or certain sodas can increase the risk of adverse effects associated with theophylline, such as increased heart rate or nervousness. Hence, avoiding caffeinated beverages is advisable to minimize the risk of exacerbating these effects.
Choice D Reason:
"Take the medication with meals." Taking theophylline with or without meals is typically acceptable, but it's essential to maintain consistency in timing and avoid significant changes in dietary habits that might affect its absorption or metabolism.

Choice A Reason:
Decreased respiratory rate is incorrect. Heparin administration and an elevated aPTT typically do not directly cause a decrease in respiratory rate. Respiratory rate changes might occur due to other factors such as respiratory conditions, pain, or medications affecting the respiratory center, but they are not commonly linked to heparin therapy.
Choice B Reason:
Increased blood pressure is incorrect. Heparin therapy and an elevated aPTT do not typically result in increased blood pressure. Heparin's primary effect is on preventing blood clotting, and while it can indirectly affect blood pressure by preventing clot formation, it doesn't typically cause a significant increase in blood pressure.
Choice C Reason:
Decreased temperature is incorrect. Heparin therapy and an elevated aPTT do not generally cause a decrease in body temperature. Changes in body temperature might occur due to various reasons such as infection, environmental factors, or certain medications, but they are not directly linked to heparin administration.
Choice D Reason:
Increased pulse rate is correct. An increased pulse rate can be an early indicator of bleeding or a potential side effect of heparin administration. Heparin's anticoagulant effect might predispose individuals to bleeding, so an increased pulse rate could indicate a response to potential bleeding complications rather than a direct effect of heparin itself.