The nurse should question an order for bismuth salts for a client with what condition?

Octreotide is a synthetic analog of somatostatin, a hormone that inhibits the secretion of growth hormone, insulin, glucagon, and other hormones. Octreotide can cause gastrointestinal side effects such as abdominal pain, diarrhea, constipation, nausea, vomiting, and flatulence. These side effects are more common and severe with the oral route than with the injectable route.

Choice B is wrong because tinnitus, or ringing in the ears, is not a common or serious side effect of octreotide.

Choice C is wrong because alteration in consciousness is not a common or serious side effect of octreotide.

However, octreotide can affect blood glucose levels and cause hypoglycemia or hyperglycemia, which can lead to confusion, dizziness, fainting, seizures, or coma in severe cases.

Choice D is wrong because changes in vision are not a common or serious side effect of octreotide.

However, octreotide can cause rare but serious eye problems such as blurred vision, double vision, eye pain, or blindness due to optic nerve damage or retinal detachment.

These eye problems require immediate medical attention.

Normal ranges for blood glucose are 70 to 100 mg/dL (3.9 to 5.6 mmol/L) for fasting and less than 140 mg/dL (7.8 mmol/L) for postprandial.

The nurse should ask this question because the client is taking a chemical stimulant laxative, which can cause dehydration and electrolyte imbalance, especially in combination with medications for heart failure and osteoarthritis that may also affect fluid and electrolyte balance. The nurse should assess the client’s hydration status and risk of hypovolemia or hypotension.

Choice B. Timing of medication administration is wrong because it is not the priority question in this situation.

The nurse should ask this question later to determine if the client is taking the medications as prescribed and if there are any drug interactions or adverse effects.

Choice C. Previous effectiveness of laxatives is wrong because it is not relevant to the client’s current condition.

The nurse should ask this question later to evaluate the client’s bowel habits and history of constipation.

Choice D. The amount of fiber intake is wrong because it is not the priority question in this situation.

The nurse should ask this question later to educate the client about dietary measures to prevent constipation and promote bowel health.