The nurse recognizes that which diagnostic test is used to detect the most common cause of chronic iron deficiency anemia?

Choice A reason: This is not the best nursing action. Documenting the pulse rate and administering the medications as prescribed may be harmful to the client. Atenolol and diltiazem are both medications that lower the blood pressure and the heart rate. Atenolol is a beta blocker that blocks the effects of adrenaline on the heart and blood vessels. Diltiazem is a calcium channel blocker that relaxes the muscles of the heart and blood vessels. Giving both medications to a client who already has a low and irregular heart rate may cause further bradycardia, which is a heart rate below 60 beats/minute, or arrhythmia, which is an abnormal heart rhythm. The nurse should check the parameters and the contraindications for the medications before administering them.

Choice B reason: This is not the best nursing action. Assessing for chest pain and administering atenolol if pain free may not be appropriate for the client. Chest pain can be a sign of angina or myocardial infarction, which are conditions where the blood flow to the heart is reduced or blocked. Atenolol can help relieve chest pain by reducing the oxygen demand of the heart, but it can also lower the heart rate and the blood pressure. The client already has a low and irregular heart rate, which may indicate a problem with the electrical conduction of the heart. The nurse should not give atenolol without checking the pulse rate and the blood pressure, and consulting the health care provider.

Choice C reason: This is the best nursing action. Holding the atenolol and administering the diltiazem is the most appropriate for the client. Atenolol can lower the heart rate and the blood pressure, which may worsen the client's condition. The nurse should hold the atenolol and notify the health care provider of the client's pulse rate and rhythm. Diltiazem can also lower the heart rate and the blood pressure, but it can also help regulate the heart rhythm by slowing down the electrical impulses in the heart. The nurse should administer the diltiazem as prescribed, and monitor the client's vital signs and cardiac status.

Choice D reason: This is not the best nursing action. Withholding the medications and reassessing the heart rate in 30 minutes may delay the treatment and the care of the client. The client has a low and irregular heart rate, which may indicate a serious cardiac problem that needs immediate attention. The nurse should not wait for 30 minutes to reassess the heart rate, but rather act promptly and notify the health care provider. The nurse should also administer the diltiazem as prescribed, unless there is a specific reason to withhold it.

Choice A reason: I should continue to read the labels of foods I select at the grocery store is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands the importance of choosing foods that are low in sodium, fat, and calories, which can help lower blood pressure and prevent complications.

Choice B reason: Keeping my blood pressure under control reduces my risk for a heart attack is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands the benefits of pharmacologic therapy for hypertension, which can prevent or delay the development of cardiovascular disease.

Choice C reason: When I get out of bed in the morning, I should first sit for a few minutes and then stand is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands how to prevent or minimize orthostatic hypotension, which is a possible side effect of some anti-hypertensive medications.

Choice D reason: I will be able to stop my anti-hypertensive medication when my blood pressure is normal is a statement that indicates a need for further clarification by the nurse. This statement shows that the client has a misconception about the nature and duration of pharmacologic therapy for hypertension. The nurse should explain that hypertension is a chronic condition that requires lifelong treatment and monitoring, and that stopping the medication abruptly can cause a rebound increase in blood pressure and increase the risk of complications.