A female client with asthma arrives at the clinic with severe seasonal allergy congestion. On review of the client's current medication list, the practical nurse (PN) notices the client is taking tiotropium bromide and albuterol inhalation for asthma, as well as oral contraceptive ethinyl estradiol/norethindrone. The client receives new prescriptions for hydrocortisone and pseudoephedrine to treat the allergy symptoms. Which medication(s) should the PN reinforce as having the potential to increase the client's blood pressure?

Choice A reason: Lymph nodes are important components of the immune system and play a crucial role in filtering harmful substances and housing lymphocytes. While HIV/AIDS can affect lymph nodes, it is not the primary target of the virus.
Choice B reason: The spleen is another vital organ in the immune system that helps filter blood and fight infections. However, it is not the specific target of HIV.
Choice C reason: T cells, specifically CD4+ T cells, are the main target of HIV (the virus that causes AIDS). HIV infects and destroys these cells, leading to a weakened immune system. The progressive loss of CD4+ T cells impairs the body's ability to fight off infections and certain cancers, which is characteristic of AIDS.
Choice D reason: B cells are responsible for producing antibodies and play a key role in the humoral immune response. While HIV/AIDS can indirectly impact B cell function due to the overall compromised immune system, B cells are not the primary cells affected by the virus.

Choice A reason: Assessing the mucous membranes can provide useful information about the client’s overall hydration status. Checking for signs of dehydration, such as dry or sticky mucous membranes, can indicate whether the client may need additional fluids or intervention. However, this assessment does not directly address the issue of decreased urine output in the catheter, which might be due to a blockage or mechanical issue with the catheter itself.
Choice B reason: Ensuring that the catheter tubing is straight is crucial because any kinks or bends in the tubing can obstruct the flow of urine, leading to decreased urine output. This is a simple yet essential step that can be quickly performed by the practical nurse to rule out mechanical obstruction as the cause of the problem. By straightening the tubing, the nurse can help restore proper urine flow without the need for further invasive interventions.
Choice C reason: Auscultating lung sounds is an important assessment to determine if the client has any respiratory complications, such as fluid overload or pneumonia, which can sometimes occur post-transplant. While this is a critical assessment for overall health, it does not directly address the immediate issue of decreased urine output in the catheter. It is important to prioritize assessments that are directly related to the symptom being observed.
Choice D reason: Determining the dryness of bed linens can help assess if there has been any urine leakage around the catheter site or if the catheter is not functioning properly. Wet bed linens might indicate that the urine is bypassing the catheter or that there is a leak in the system. However, this assessment alone may not provide enough information to address the decreased urine output and should be combined with other assessments like ensuring the catheter tubing is straight.
Choice E reason: Irrigating the catheter to assess patency is a direct and immediate action that can help identify if the catheter is blocked. If there is resistance during irrigation, it indicates that the catheter may be obstructed, and further action is required to clear the blockage. This assessment can help resolve the issue of decreased urine output and is a practical step before notifying the charge nurse, as it provides a clear indication of the catheter's functionality.