A nurse on the Cardiovascular unit is completing the patient's history and physical examination. Which of the following information provided by the patient should the nurse consider as subjective data?

Choice A rationale:

A macular rash on the chest and back is not indicative of a paradoxical drug reaction to lorazepam, a benzodiazepine. Paradoxical reactions involve unexpected and opposite responses to a medication, such as increased agitation and excitement instead of the intended calming effect. A rash is not consistent with this type of reaction.

Choice B rationale:

Increased appetite is not associated with a paradoxical drug reaction to lorazepam. Paradoxical reactions involve behavioral and physiological responses that are contrary to the expected effects of the medication. Increased appetite does not fit this pattern.

Choice C rationale:

Drowsiness and mild sedation are the intended effects of lorazepam, a benzodiazepine. Paradoxical reactions are characterized by unexpected and opposite responses. Drowsiness and mild sedation align with the expected pharmacological actions of benzodiazepines, making this choice incorrect for a paradoxical reaction.

Choice D rationale:

Increased agitation and insomnia are indicative of a paradoxical drug reaction to lorazepam. Benzodiazepines like lorazepam are central nervous system depressants and are commonly used to treat anxiety and promote sedation. However, in some cases, paradoxical reactions can occur, leading to increased agitation, excitement, and even insomnia. These reactions are thought to be more common in children and older adults. This choice is correct because it aligns with the characteristics of a paradoxical reaction.

Choice A rationale:

Placing the client in airborne isolation is a priority because measles is highly contagious and spread through airborne droplets. Airborne precautions are necessary to prevent the transmission of pathogens that can remain suspended in the air for longer periods. Measles is known for its high infectivity, and isolating the client in a negative pressure room equipped with HEPA filtration can help prevent the spread of the virus to other patients and healthcare workers.

Choice B rationale:

While advising family members not to bring flowers into the room is a reasonable infection control measure, it is not the priority action in this scenario. The immediate concern is to prevent the spread of the highly contagious measles virus through airborne transmission.

Choice C rationale:

Obtaining a sputum sample for culture is not the priority action in this situation. Measles is a viral infection, and sputum cultures are typically used to identify bacterial infections. Additionally, the primary mode of transmission for measles is through airborne droplets, so preventing its spread takes precedence over obtaining a sputum sample.

Choice D rationale:

Placing the client on contact precaution is not the correct choice for managing measles. Measles is primarily transmitted through the airborne route, so airborne precautions, not contact precautions, are necessary to prevent its transmission.