The client with pernicious anemia asks why vitamin B12 injections are necessary. What is the best response by the nurse?

hoice A reason: Preparing for endotracheal intubation and ventilatory support is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with respiratory failure or impending airway obstruction, which are not the case for this client.

Choice B reason: Providing continuous sedation for pain relief is not the action that the nurse should take for a client with thyroid storm. This intervention may worsen the client's condition by suppressing the respiratory drive and lowering the blood pressure. The nurse should administer antithyroid medications, beta blockers, and corticosteroids as prescribed to reduce the thyroid hormone levels and the associated symptoms.

Choice C reason: Initiating cardiac monitoring and assessing for reflex bradycardia is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with hyperkalemia or digoxin toxicity, which are not the case for this client. The nurse should monitor the client's heart rate and rhythm, but not expect a reflex bradycardia, which is a paradoxical slowing of the heart rate in response to a rapid rise in blood pressure.

Choice D reason: Maintaining IV fluid infusion and assessing adequacy of hydration is the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with thyroid storm, as they are at risk of dehydration and electrolyte imbalance due to increased metabolic rate, fever, sweating, vomiting, and diarrhea. The nurse should administer isotonic fluids, such as normal saline, and monitor the client's fluid intake and output, urine specific gravity, and serum electrolytes.

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.