After administering sublingual nitroglycerin to a client with chest pain, it is most important for the nurse to assess:

Choice A reason: This is correct. The kidneys are the main organs for excreting water-soluble substances, including most drugs and their metabolites. The kidneys filter the blood and remove waste products and excess fluid as urine. Drugs can be excreted by glomerular filtration, tubular secretion, or tubular reabsorption.

Choice B reason: This is incorrect. The pancreas is not involved in excretion of drugs. The pancreas is an organ that produces digestive enzymes and hormones, such as insulin and glucagon.

Choice C reason: This is incorrect. The gallbladder is not involved in excretion of drugs. The gallbladder is an organ that stores and concentrates bile, a fluid that helps digest fats.

Choice D reason: This is incorrect. The liver is not primarily responsible for excretion of drugs, although it plays an important role in drug metabolism. The liver is an organ that performs many functions, such as detoxifying substances, synthesizing proteins, and producing bile. The liver can transform drugs into more polar and water-soluble compounds, which can then be excreted by the kidneys or the biliary system.

Choice A reason: Limit caffeine intake is not an instruction that the nurse should provide to the client who has asthma and a new prescription for inhaled fluticasone. Fluticasone is a medication that reduces inflammation and swelling in the airways, which can improve breathing and prevent asthma attacks. Fluticasone does not interact with caffeine or affect the heart rate or blood pressure. Caffeine is a stimulant that can cause nervousness, insomnia, or palpitations in some people, but it does not worsen asthma symptoms or interfere with fluticasone therapy. The nurse should advise the client to consume caffeine in moderation and avoid it before bedtime.

Choice B reason: Take the medication with meals is not an instruction that the nurse should provide to the client who has asthma and a new prescription for inhaled fluticasone. Fluticasone is a medication that reduces inflammation and swelling in the airways, which can improve breathing and prevent asthma attacks. Fluticasone is administered by inhalation, not by mouth, and it does not affect the digestion or absorption of food. The nurse should instruct the client to use the inhaler as prescribed, usually twice a day, regardless of the mealtimes.

Choice C reason: Rinse the mouth after administration is an instruction that the nurse should provide to the client who has asthma and a new prescription for inhaled fluticasone. Fluticasone is a medication that reduces inflammation and swelling in the airways, which can improve breathing and prevent asthma attacks. Fluticasone is a corticosteroid, which can cause side effects such as oral thrush, hoarseness, or sore throat if it remains in the mouth after inhalation. The nurse should instruct the client to rinse the mouth with water and spit it out after each dose of fluticasone to prevent these side effects. The nurse should also teach the client how to use the inhaler properly and check the inhaler technique regularly.

Choice D reason: Check the pulse after medication administration is not an instruction that the nurse should provide to the client who has asthma and a new prescription for inhaled fluticasone. Fluticasone is a medication that reduces inflammation and swelling in the airways, which can improve breathing and prevent asthma attacks. Fluticasone does not affect the heart rate or blood pressure, and it is not a rescue medication that should be used for acute asthma symptoms. The nurse should monitor the respiratory rate and the oxygen saturation of the client after administering fluticasone and advise the client to use a short acting bronchodilator, such as albuterol, for quick relief of wheezing or shortness of breath.