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Takes concurrent iron therapy without adverse effects: While taking concurrent iron therapy without adverse effects is beneficial, it does not directly indicate the effectiveness of epoetin alfa. Epoetin alfa stimulates erythropoiesis, and its effectiveness is best measured by improvements in hemoglobin levels, not just the tolerance of iron supplementation.

Reports of increased energy levels and decreased fatigue: Reports of increased energy levels and decreased fatigue are positive signs but are subjective and not specific indicators of epoetin alfa's effectiveness. The most reliable measure of the medication's impact is the objective increase in hemoglobin levels.

Food diary shows increased consumption of iron-rich foods: Increased consumption of iron-rich foods is beneficial for supporting erythropoiesis but does not directly measure the effectiveness of epoetin alfa. The primary measure of the medication's success is the increase in hemoglobin levels, rather than dietary changes alone

When using the discus, have the client breathe out rapidly into the mouthpiece: This instruction is incorrect because the client should not breathe out into the discus mouthpiece. Exhaling into the device could result in moisture entering the discus, which may cause the medication powder to clump, reducing the dose received and potentially making the device unusable.

Offer the discus to the client for use during an acute asthma attack: This is not appropriate because fluticasone and salmeterol discus is not a rescue inhaler. It is a long-acting bronchodilator and corticosteroid combination meant for maintenance therapy, not for quick relief during an acute asthma attack. Short-acting bronchodilators like albuterol are used for immediate relief.

Clients using the discus may experience decreased blood pressure: There is no known association between the use of the fluticasone/salmeterol discus and decreased blood pressure. The primary side effects associated with this medication include potential respiratory effects, such as throat irritation, and not systemic cardiovascular effects like low blood pressure.

Initiate cardiopulmonary resuscitation (CPR):While initiating CPR is critical for clients experiencing cardiac or respiratory arrest, it is not the immediate action in this scenario. The client’s respiratory depression is most likely related to opioid toxicity, which can sometimes be reversed with naloxone. Before resorting to CPR, the priority is to address the potential cause of the respiratory depression.

Prepare to assist with chest tube insertion:Chest tube insertion is typically indicated for conditions such as pneumothorax or pleural effusion, not for opioid-induced respiratory depression. In this case, the client’s symptoms are likely related to the effects of opioids and naloxone administration, not a need for chest tube insertion

Determine Glasgow Coma Scale score:While assessing the Glasgow Coma Scale (GCS) score is important for evaluating the client's level of consciousness and neurological status, it does not address the immediate need to counteract opioid toxicity. The priority is to manage the respiratory depression that could be life-threatening.

Continue with normal dose schedule after missing a dose:If a dose of sucralfate is missed, continuing with the normal dosing schedule without additional instructions is not appropriate. Sucralfate is best taken on an empty stomach to ensure optimal effectiveness, so missing a dose may require specific instructions to address this.

Administer an additional dose if a dose is missed:Taking an additional dose of sucralfate if one is missed is not recommended. This could lead to an overdose or increased side effects. The proper approach is to follow specific instructions for missed doses provided by the healthcare provider or the medication guidelines.

Schedule doses with each meal and at bedtime:While sucralfate is often taken multiple times a day, scheduling doses specifically with meals and at bedtime may not be ideal. The medication should be taken on an empty stomach, and scheduling around meals could interfere with its efficacy. Following the specific instruction of taking it at least 1 hour before meals ensures better adherence to its treatment protocol.

Adding the herb can decrease the need for corticosteroids:There is no substantial evidence to suggest that St. John's Wort affects the need for corticosteroids. This herb's primary concern in the context of a renal transplant is its interaction with other medications rather than altering corticosteroid requirements.

The client probably used this herb to treat depression:While St. John's Wort is commonly used for its antidepressant effects, this information, while relevant, does not directly address the critical issue of drug interactions that can affect transplant medication efficacy.

Ingestion of St. John's Wort can reduce the client’s intake of sodium:St. John's Wort does not have a direct impact on sodium intake or levels. Its primary concern in the context of drug interactions is related to how it affects other medications rather than influencing sodium levels.

Consult with a pharmacist about scheduling the dose one hour after the client eats:Risedronate should be taken on an empty stomach and not with food or beverages other than water. Scheduling the dose after the client eats does not address the critical issue of how the medication interacts with food, and consulting a pharmacist for this reason might not be the most immediate action.

Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk:Bringing a glass of milk to the client contradicts the instructions for risedronate administration. The medication should not be taken with any food or drink other than water to ensure proper absorption and effectiveness.

Withhold the medication until the client’s breakfast tray is available on the unit:Withholding the medication until the breakfast tray is available does not resolve the issue of proper administration. Risedronate should be taken on an empty stomach, and providing breakfast would not be appropriate if it interferes with the medication’s absorption.

Pulse rate:While monitoring the pulse rate is important for assessing overall cardiovascular function, it is not the most immediate concern when a client becomes lethargic after receiving an opioid. Opioids are known to potentially cause respiratory depression, which is a more critical issue to address first.

Blood pressure:Blood pressure changes can occur with opioid use, but in the context of sudden lethargy, the primary concern is to check for respiratory depression. This condition can lead to significant complications and requires immediate attention.

Temperature:Temperature monitoring is important for identifying infection or other issues, but it is not the most relevant vital sign to assess immediately after noticing lethargy from opioid administration. Respiratory rate is more directly affected by opioids.

Serum ammonia level of 30 μg/dl (17.62 μmol/dL):Sodium polystyrene sulfonate is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestine. It does not affect serum ammonia levels, which are more relevant in cases of liver dysfunction or urea cycle disorders. Thus, this finding does not indicate the effectiveness of the medication.

Hemoglobin level of 13.5 g/dL (135 g/L):Hemoglobin levels are related to anemia or blood disorders and are not directly affected by sodium polystyrene sulfonate. This lab result would not indicate the effectiveness of the medication in managing potassium levels.

Serum glucose level of 120 mg/dL (6.7 mmol/L):While glucose levels are important for overall metabolic management, they are not directly impacted by sodium polystyrene sulfonate. This result would not reflect the effectiveness of the medication in treating elevated potassium levels in acute kidney injury.

Use relaxation techniques to reduce excessive anxiety:This statement is appropriate as combining relaxation techniques with pharmacological treatment can help manage anxiety symptoms more effectively. Encouraging non-pharmacological strategies is a good complement to medication.

Avoid alcohol and other sedatives while taking the medication:This statement is accurate and crucial. Lorazepam is a benzodiazepine, and combining it with alcohol or other sedatives can increase the risk of severe sedation, respiratory depression, and other dangerous side effects. Avoiding these substances is essential for safety.

Move slowly from a sitting position to a standing position:This recommendation is important because lorazepam can cause dizziness or orthostatic hypotension. Moving slowly helps to prevent falls and minimize the risk of injury related to sudden changes in position.

Daily calorie count:While tracking daily calorie intake can provide insight into the client’s adherence to dietary recommendations, it is not a direct measure of the effectiveness of orlistat. The medication's impact is better evaluated through changes in body weight and BMI rather than daily calorie consumption alone.

Depression screening:Although managing weight can impact mental health, depression screening is not directly related to assessing the effectiveness of orlistat. The primary focus should be on evaluating weight changes and BMI, not mental health assessments.

Serum protein levels:Orlistat can affect the absorption of fat-soluble vitamins, but monitoring serum protein levels is not a direct measure of the medication’s effectiveness. Instead, changes in body weight and BMI are more relevant for evaluating the impact of orlistat on weight management