Exhibits

The provider would like the client to continue with the captopril dose and restart the spironolactone. The provider wants the client to return to the clinic in 6 weeks with lab work done.

What 2 labs would be most appropriate for this client to complete on their return visit?

Choice A rationale: Indicated. This is important for a client with type 1 diabetes, as counting carbohydrates helps in calculating the appropriate insulin dose and maintaining glycemic control.

Choice B rationale: Non-essential. The client is already admitted to the surgical floor and does not require restarting the IV fluids unless there is a specific medical indication.

Choice C rationale: Contraindicated. Insulin doses should be prescribed by a healthcare provider based on the patient's blood glucose levels and individual insulin requirements. The nurse should follow the prescribed insulin orders and not administer insulin without an order.

Choice D rationale: Indicated. Insulin glargine is a long-acting basal insulin used to provide a steady background insulin level throughout the day. The nurse should administer the prescribed insulin glargine dose as ordered.

Choice E rationale: Contraindicated. Insulin lispro is a rapid-acting insulin, and insulin glargine is a long-acting insulin. Mixing different types of insulin in one syringe can alter their pharmacokinetics and lead to inconsistent blood glucose control. Insulin lispro and insulin glargine should be administered separately.

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.