For a client with a new prescription for the cholesterol medication gemfibrozil, the nurse instructs the client to immediately report what symptoms?

Choice A reason: This choice is incorrect because checking the apical heart rate before taking calcium channel blockers is not necessary for most patients. Calcium channel blockers are a group of medications that relax and widen blood vessels, lower blood pressure, and slow the heart rate. They are used to treat conditions such as hypertension, angina, and arrhythmias. The nurse should check the apical heart rate only if the patient has a history of bradycardia (slow heart rate) or heart block (a problem with the electrical conduction of the heart).

Choice B reason: This choice is incorrect because calcium channel blockers do not cause increased blood pressure, but rather lower it. Blurred vision is not a common side effect of calcium channel blockers, and it may indicate other problems, such as eye infection, glaucoma, or stroke. The nurse should instruct the patient to report any changes in vision, but not to associate them with calcium channel blockers.

Choice C reason: This choice is incorrect because calcium channel blockers do not affect cholesterol levels, and the time of day they are taken does not matter. Cholesterol is a type of fat that circulates in the blood and can build up in the arteries, causing atherosclerosis (hardening and narrowing of the arteries). Cholesterol levels are influenced by diet, exercise, genetics, and other medications, such as statins. The nurse should advise the patient to follow a healthy lifestyle and take any prescribed medications for cholesterol control.

Choice D reason: This choice is correct because grapefruit juice can interact with some calcium channel blockers, such as nifedipine, verapamil, and diltiazem, and increase their blood levels and effects. This can cause serious side effects, such as low blood pressure, dizziness, headache, flushing, and edema (swelling). The nurse should warn the patient to avoid grapefruit juice and any products that contain grapefruit while taking calcium channel blockers.

Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.

Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.

Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.

Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.