Exhibits

The nurse should plan to first administer 

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 followed by 

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B. Slowing the infusion rate of 0.9% sodium chloride and contacting the provider are appropriate initial actions to manage the client's dyspnea and hypertension, which are likely due to fluid overload from the IV infusion.

A Corticosteroids are not typically indicated for dyspnea and hypertension related to IV fluid administration with 0.9% sodium chloride.

C Changing the type of IV fluid to lactated Ringer's solution may be considered in some cases to address fluid balance issues. However, this decision should be made in consultation with the healthcare provider based on the client's specific clinical condition and fluid status.

D. Lowering the head of the bed to semi-Fowler's position can help improve respiratory function and reduce dyspnea. However, this action alone does not address the underlying cause of the client's symptoms.

C. Atropine is an anticholinergic medication that increases heart rate by blocking vagal tone to the heart. It is used to treat symptomatic bradycardia, including sinus bradycardia that causes hemodynamic instability

A Lidocaine is primarily used for the treatment of ventricular arrhythmias, particularly in the setting of acute myocardial infarction or during cardiac arrest. Sinus bradycardia with S-T segment elevation suggests ischemia or injury to the heart muscle (myocardium) rather than ventricular arrhythmias.

B. Digoxin is a medication used to increase myocardial contractility and reduce heart rate in certain heart conditions such as atrial fibrillation or heart failure. It is not typically indicated for acute management of sinus bradycardia

D. Sotalol is a beta-blocker with class III antiarrhythmic properties. It is used primarily for the management of atrial and ventricular arrhythmias, not for acute coronary syndrome or sinus bradycardia with myocardial ischemia.