A client diagnosed with a PE is placed on a heparin drip. The nurse knows that she must monitor which of the following?

A. Productive cough and crackles:These are hallmark signs of pneumonia. A productive cough indicates mucus in the airways, while crackles on auscultation suggest fluid and inflammation in the alveoli, consistent with lower respiratory tract infection.

B. Bradycardia and hypotension:Bradycardia is not typically associated with pneumonia. Hypotension can occur in severe or septic cases, but it is not specific or diagnostic. Neither finding is present in this case, nor do they support the pneumonia diagnosis.

C. Elevated WBC and hypertension:An elevated WBC count does support infection, but hypertension is not characteristic of pneumonia. Blood pressure changes are not diagnostic and may vary based on the individual’s baseline or stress response.

D. Decreased WBC & clear lung sounds:A low WBC count and clear lung sounds argue against an infectious process like pneumonia. These findings would more likely suggest that infection is absent or resolving, not active.

A. Physical therapy for homebound therapy services:Physical therapy is not routinely indicated in TB management unless the patient has specific mobility deficits. TB treatment focuses more on medication adherence and infection control rather than physical rehabilitation.

B. Occupational therapy for job retraining:There is no direct indication for job retraining in a TB patient unless the illness has caused long-term disability or affected occupational function, which is not suggested in this scenario.

C. Community social worker for Meals on Wheels:Meals on Wheels may assist with nutrition, but it is not specific to TB care. Social services do not directly ensure adherence to TB therapy, which is crucial for treatment success and public health safety.

D. Visiting Nurses for directly observed therapy:Directly observed therapy (DOT) ensures the client takes prescribed TB medications under supervision, which is essential to prevent noncompliance, reduce drug resistance, and promote cure. Visiting nurses are best positioned to provide this support during long-term outpatient TB treatment.