Exhibits

The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril.

Which ACE inhibitors can be given only once per day? Select all that apply.

A. A scratchy throat can be an early sign of an allergic reaction to the antibiotic, which could progress to anaphylaxis if the infusion continues. Immediate cessation of the infusion is essential to prevent serious complications, and the nurse should notify the provider and initiate emergency interventions if needed.

B. Pupillary constriction is not a typical sign of an acute allergic reaction to piperacillin-tazobactam and does not warrant stopping the infusion.

C. Hypertension is not an expected early manifestation of an allergic reaction to this antibiotic. Blood pressure changes are more likely to occur later if anaphylaxis develops.

D. Bradycardia is not commonly associated with an early allergic reaction to antibiotics and does not require immediate cessation of the infusion unless other signs of anaphylaxis are present.

Choice A rationale: Nausea is the symptom the medication is intended to treat, and it is expected that the client may have some level of nausea while undergoing chemotherapy. It is not the most important adverse effect to report in this scenario.

Choice B rationale: Diarrhea is not a common or significant adverse effect of metoclopramide. While it is essential to monitor for any gastrointestinal side effects, it is not the most important adverse effect to report in this case.

Choice C rationale: Metoclopramide is a medication commonly used to treat nausea and vomiting, particularly related to chemotherapy. One of the significant adverse effects of metoclopramide is the potential to cause extrapyramidal symptoms, including involuntary movements such as dystonia, dyskinesia, and Parkinsonism. These extrapyramidal symptoms can be serious and may require immediate intervention or discontinuation of the medication.

Therefore, it is essential for the nurse to closely monitor the client for any signs of involuntary movements and report them promptly to the healthcare provider for appropriate management.

Choice D rationale: Unusual irritability is not a typical adverse effect associated with metoclopramide. While mood changes can occur with any medication, involuntary movements are a more concerning side effect that requires immediate attention and reporting.