An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)

Choice A reason: Hypercholesterolemia, or high cholesterol, is not a primary concern when prescribing methylphenidate. While managing cholesterol levels is important for overall cardiovascular health, it does not directly interact with the administration of methylphenidate.

Choice B reason: Hypertension, or high blood pressure, is a critical condition to review before administering methylphenidate. Methylphenidate can increase blood pressure and heart rate, potentially exacerbating pre-existing hypertension. Monitoring and managing blood pressure is essential to prevent complications such as stroke or heart attack.

Choice C reason: Diabetes mellitus is important to manage, but it is not directly affected by methylphenidate. While some medications can influence blood sugar levels, methylphenidate primarily affects the central nervous system and cardiovascular system.

Choice D reason: Bronchitis, an inflammation of the bronchial tubes, is not a primary concern with methylphenidate use. Although respiratory conditions should be managed appropriately, they do not typically interact with the effects of methylphenidate.

Choice A reason:

A CT scan performed six months earlier does not typically require follow-up unless there were specific findings or complications from the previous scan. The timing of the previous scan is not a contraindication for a new CT scan with contrast. However, it is always good practice to review previous imaging results to compare and assess any changes.

Choice B reason:

Metformin hydrochloride is a medication used to manage type 2 diabetes mellitus. It is important to follow up on this information because metformin can interact with the contrast dye used in CT scans. The combination can increase the risk of lactic acidosis, a rare but serious complication. Therefore, it is crucial to assess kidney function and possibly withhold metformin before and after the procedure to reduce this risk.

Choice C reason:

A report of the client’s sobriety for the last five years is generally a positive aspect of their medical history and does not require follow-up in the context of a CT scan with contrast. Sobriety does not impact the safety or efficacy of the contrast dye used in the scan.

Choice D reason:

A metal hip prosthesis placed twenty years ago is relevant information but does not typically require follow-up before a CT scan. Unlike MRI, where metal implants can cause issues, CT scans are generally safe for patients with metal prostheses. However, the presence of metal can sometimes affect the quality of the images, so it is important for the radiologist to be aware of it.