The nurse continues to care for the client who is at 30 weeks of

Exhibits

Complete the following sentence by using the lists of options.

Based on the client findings, the nurse should first

dropdown

and then prepare to administer

dropdown

.

Rationale for Correct Answers:

• LDL level: An LDL level of 145 mg/dL exceeds the recommended limit (<130 mg/dL), increasing the client’s risk for atherosclerosis and coronary artery disease. Elevated LDL contributes to plaque buildup in arterial walls, narrowing the vessels and raising the likelihood of myocardial infarction and stroke.
• BMI: A BMI of 29.8 falls in the overweight range (25–29.9), nearing obesity. Excess body weight, particularly visceral fat, is associated with hypertension, insulin resistance, and dyslipidemia, all of which are significant risk factors for cardiovascular disease.

Rationale for Incorrect Answers:

• Exercise: The client walks 30 minutes 5 days a week, meeting the American Heart Association’s guidelines for physical activity. Regular aerobic exercise reduces blood pressure, improves lipid profiles, and strengthens cardiac function.
• Diet: The client reports following a Mediterranean diet, which is associated with lower cardiovascular risk due to its emphasis on fruits, vegetables, whole grains, lean protein, and healthy fats. Although wine consumption is noted, moderation aligns with Mediterranean patterns.
• HDL level: The client’s HDL is 58 mg/dL, which is above the desired threshold (>55 mg/dL). Higher HDL levels offer cardioprotective effects by helping remove cholesterol from the bloodstream and reducing the risk of plaque buildup.

A. "You may experience a decrease in your blood pressure while taking this medication.": Orthostatic hypotension is a possible side effect, but it's not as common or specific as sedation-related concerns for this medication.
B. "You may experience weight loss while taking this medication.": Doxepin, a tricyclic antidepressant, is more commonly associated with weight gain due to increased appetite, not weight loss.
C. "You may experience diarrhea while taking this medication.": Doxepin is more likely to cause constipation rather than diarrhea due to its anticholinergic effects.
D. "You may experience insomnia if you take this medication later in the day.": Doxepin has sedative properties. Taking it late in the day can disrupt the natural sleep-wake cycle, paradoxically leading to sleep disturbances or difficulty initiating restful sleep.