The nurse is caring for a client who is being treated for peptic ulcer disease. Which medication should the client be taught to avoid?

A) Lowered heart rate:
Dopamine typically increases heart rate as it acts on beta-adrenergic receptors in the heart, leading to increased cardiac contractility and chronotropy. However, at low doses, the effect on heart rate may be minimal compared to higher doses.

B) Decreased conduction through the AV node:
Dopamine may have minimal effects on conduction through the atrioventricular (AV) node, especially at low doses. It primarily acts on adrenergic receptors to increase cardiac contractility and heart rate.

C) Increased urine output.
Dopamine is a medication commonly used to treat shock by improving cardiac output and blood pressure. At low doses, dopamine primarily acts on dopamine receptors in the renal blood vessels, causing vasodilation and increased renal blood flow. This increased renal blood flow leads to increased glomerular filtration rate (GFR) and urine output. Therefore, increased urine output is an expected effect of dopamine infusion at low doses in the treatment of shock.

D) Vasoconstriction of renal blood vessels:
At low doses, dopamine primarily acts on dopamine receptors in the renal blood vessels, causing vasodilation and increased renal blood flow. Vasoconstriction of renal blood vessels is more commonly associated with higher doses of dopamine or with other vasopressor medications such as norepinephrine or phenylephrine.

A. This is normal.
Guaifenesin is an expectorant medication commonly used to help loosen and thin mucus in the airways, making it easier to cough up. Coughing up phlegm after taking guaifenesin is a typical and expected response to the medication. Therefore, reassuring the client that this is a normal effect of the medication is appropriate.

B. This requires further investigation: Coughing up phlegm after taking guaifenesin is a common and expected outcome, so further investigation is not necessary unless there are other concerning symptoms or indications.

C. This is indicative of an allergic reaction: Coughing up phlegm after taking guaifenesin is not indicative of an allergic reaction. Allergic reactions to guaifenesin are rare and typically present with more severe symptoms such as rash, itching, swelling, or difficulty breathing.

D. This means there is probably more pathology present: Coughing up phlegm after taking guaifenesin does not necessarily indicate the presence of additional pathology. Guaifenesin is intended to help clear mucus from the airways and is commonly used in the treatment of respiratory conditions associated with excess mucus production, such as cough due to cold or bronchitis.