A quality control nurse is reviewing medication prescriptions for a group of clients. Which of the following medication prescriptions should the nurse identify as being complete?

Rationale:

A. Skin cool to touch: Cool skin is more commonly associated with shock states or severe peripheral vasoconstriction, not with a hypertensive crisis. In hypertensive crisis, the client is more likely to have warm skin due to increased circulation from elevated blood pressure.

B. Jugular vein distention: While jugular vein distention can occur in right-sided heart failure or severe fluid overload, it is not a hallmark manifestation of hypertensive crisis. The acute issue in hypertensive crisis is extreme elevation in blood pressure with end-organ effects.

C. Headache: Severe headache is a common and classic symptom of hypertensive crisis due to sudden, extreme elevations in blood pressure causing increased ICP and cerebral vessel stress. It often signals an urgent need for BP control to prevent complications such as stroke.

D. Weak peripheral pulses: Weak pulses are more often associated with low cardiac output or severe arterial obstruction. In hypertensive crisis, peripheral pulses are typically bounding and strong because of the elevated systemic vascular resistance.

A. Apply lidocaine gel around the incision: Topical lidocaine is generally used for localized superficial pain, not for deep postoperative pain following major joint surgery. Its effectiveness for a knee arthroplasty incision is limited.

B. Attach a transcutaneous electrical nerve stimulation unit around the incision: TENS units can help with some types of pain but are more effective for chronic musculoskeletal pain rather than acute postoperative pain.

C. Place a cold pack over the incision: Cold therapy reduces inflammation, swelling, and pain in the immediate postoperative period. It is a safe and effective nonpharmacological intervention for mild to moderate pain following knee arthroplasty.

D. Assist the client for a walk in the hallway: Early ambulation is important for preventing complications and promoting recovery, but it may initially increase pain when the client is only 4 hours post-surgery. Cold therapy is more appropriate for immediate pain relief.