The client diagnosed with vitamin B12 deficiency presents to the outpatient department for the follow-up evaluation. Which nursing assessment finding indicates that the treatment has been effective? The client:

Choice A reason: This is not a correct answer. A decrease in urination is not a common side effect of amlodipine. Amlodipine is a calcium channel blocker that lowers the blood pressure and relaxes the blood vessels. Amlodipine does not affect the kidney function or the urine output, unless there is an underlying renal problem or a drug interaction. The client should monitor their urination, but not expect a decrease.

Choice B reason: This is the correct answer. An increase in lower extremity edema is a common side effect of amlodipine. Amlodipine can cause fluid retention and swelling in the legs, ankles, or feet. This is due to the dilation of the blood vessels and the leakage of fluid into the tissues. The client should monitor their weight and the size of their lower extremities, and report any significant changes to their health care provider. The client may also elevate their legs, wear compression stockings, or take diuretics to reduce the edema.

Choice C reason: This is not a correct answer. Tachycardia during exercise is not a common side effect of amlodipine. Amlodipine can lower the heart rate and the cardiac output, which can reduce the oxygen demand of the heart. Amlodipine does not cause an increase in the heart rate, unless there is an underlying cardiac problem or a drug interaction. The client should monitor their pulse and blood pressure, but not expect tachycardia.

Choice D reason: This is not a correct answer. An increase in bowel motility is not a common side effect of amlodipine. Amlodipine does not affect the gastrointestinal system or the digestion, unless there is an allergic reaction or a drug interaction. Amlodipine can cause some gastrointestinal side effects, such as nausea, abdominal pain, or constipation, but not an increase in bowel motility. The client should monitor their bowel movements, but not expect an increase.

Choice A reason: This is not a correct answer. A decrease in urination is not a common side effect of amlodipine. Amlodipine is a calcium channel blocker that lowers the blood pressure and relaxes the blood vessels. Amlodipine does not affect the kidney function or the urine output, unless there is an underlying renal problem or a drug interaction. The client should monitor their urination, but not expect a decrease.

Choice B reason: This is the correct answer. An increase in lower extremity edema is a common side effect of amlodipine. Amlodipine can cause fluid retention and swelling in the legs, ankles, or feet. This is due to the dilation of the blood vessels and the leakage of fluid into the tissues. The client should monitor their weight and the size of their lower extremities, and report any significant changes to their health care provider. The client may also elevate their legs, wear compression stockings, or take diuretics to reduce the edema.

Choice C reason: This is not a correct answer. Tachycardia during exercise is not a common side effect of amlodipine. Amlodipine can lower the heart rate and the cardiac output, which can reduce the oxygen demand of the heart. Amlodipine does not cause an increase in the heart rate, unless there is an underlying cardiac problem or a drug interaction. The client should monitor their pulse and blood pressure, but not expect tachycardia.

Choice D reason: This is not a correct answer. An increase in bowel motility is not a common side effect of amlodipine. Amlodipine does not affect the gastrointestinal system or the digestion, unless there is an allergic reaction or a drug interaction. Amlodipine can cause some gastrointestinal side effects, such as nausea, abdominal pain, or constipation, but not an increase in bowel motility. The client should monitor their bowel movements, but not expect an increase.

Choice A reason: This is incorrect. Traveling to cities where the oxygen level is lower, such as high-altitude areas, can trigger a sickle cell crisis by reducing the amount of oxygen in the blood. People with sickle cell anemia should avoid such places or take precautions such as using supplemental oxygen¹².

Choice B reason: This is incorrect. Strenuous exercise does not prevent sickle cell crisis, but rather can cause it by increasing the body's oxygen demand and dehydration. People with sickle cell anemia should avoid overexertion and rest frequently during physical activity¹³.

Choice C reason: This is incorrect. Flying on commercial airlines is not prohibited for people with sickle cell anemia, as long as they stay hydrated and avoid alcohol and caffeine. However, some people may need to use supplemental oxygen during flights, especially if they have a history of acute chest syndrome or pulmonary hypertension¹⁴.

Choice D reason: This is correct. Drinking plenty of fluids when outside in hot weather is important for people with sickle cell anemia, as dehydration can cause the red blood cells to sickle and block blood vessels. Staying hydrated can help prevent or reduce the severity of sickle cell crises¹⁵.