What assessment should the nurse make before administering beta-adrenergic blocking agents?

A) Hypoxemia:
This is the correct answer. Atelectasis, which is the collapse or incomplete inflation of the lung, can lead to impaired gas exchange and subsequent hypoxemia. As lung volume decreases due to collapse, ventilation-perfusion (V/Q) mismatch occurs, resulting in decreased oxygenation of arterial blood. Hypoxemia is a common finding in individuals with atelectasis and may manifest as decreased oxygen saturation levels on pulse oximetry or arterial blood gas analysis.

B) Apnea:
Apnea, defined as the cessation of breathing, is not typically associated with atelectasis. While atelectasis can contribute to respiratory compromise and may result in respiratory distress, including tachypnea or increased work of breathing, it does not usually lead to complete cessation of breathing.

C) Pleural effusion:
A pleural effusion is the accumulation of fluid in the pleural space surrounding the lungs. While pleural effusion may occur concurrently with atelectasis, it is not an expected finding specifically associated with atelectasis itself. Pleural effusion may cause respiratory symptoms such as dyspnea or chest pain but is not a primary manifestation of atelectasis.

D) Dysphagia:
Dysphagia, or difficulty swallowing, is unrelated to atelectasis. While dysphagia can occur as a result of various conditions affecting the esophagus or neurological control of swallowing, it is not a typical manifestation of atelectasis. Atelectasis primarily affects the lungs and respiratory function rather than swallowing function.

A) Milk:
Milk is not known to interact significantly with verapamil. Therefore, there's no need for the client to avoid consuming milk while taking this medication.

B) Orange juice:
Orange juice does not typically interact with verapamil. However, calcium-containing foods and beverages, including orange juice, may reduce the absorption of verapamil when taken simultaneously. While the interaction is not severe, it's advisable for clients to separate the administration of verapamil from calcium-rich foods and beverages to optimize absorption.

C) Grapefruit juice:
This is the correct answer. Grapefruit juice contains compounds that inhibit the activity of cytochrome P450 enzymes, particularly CYP3A4, which are involved in the metabolism of many medications, including verapamil. Consuming grapefruit juice while taking verapamil can lead to elevated blood levels of the medication, increasing the risk of side effects and toxicity. Therefore, clients should avoid grapefruit juice while on verapamil therapy.

D) Coffee:
Coffee does not typically interact with verapamil. However, caffeine-containing beverages like coffee may exacerbate certain side effects of verapamil, such as dizziness or palpitations, due to their stimulant effects. Clients may be advised to limit caffeine intake or consume coffee in moderation while taking verapamil.