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: Water-based lubricant is essential during a Pap test to ensure the patient's comfort and ease the insertion of the speculum. It is non-irritating and does not interfere with the collection of the cervical sample, which is crucial for accurate test results.
Choice B reason: A specimen bottle is required to store and transport the collected cervical cells to the laboratory for analysis. It ensures that the sample is properly preserved and can be accurately analyzed for any abnormalities, such as precancerous or cancerous cells.
Choice C reason: A microscopic slide and spray cell fixative are necessary for preparing the collected cervical cells for microscopic examination. The fixative helps preserve the cells on the slide, preventing them from drying out or becoming damaged, which is important for accurate analysis.
Choice D reason: A disposable vaginal speculum is used to gently open the vaginal walls, providing the healthcare provider with a clear view of the cervix. This allows for the proper collection of cervical cells during the Pap test, ensuring the accuracy and reliability of the test results.
Choice E reason: A cytobrush or plastic spatula cervical sampling device is used to collect the cervical cells from the transformation zone of the cervix. These devices are designed to gather an adequate and representative sample, which is essential for the accurate detection of any cellular abnormalities.

Choice A reason: Hydrocortisone is a corticosteroid that can cause fluid retention and increase blood pressure in some individuals. It is important for the PN to monitor the client's blood pressure and educate them about this potential side effect.
Choice B reason: Tiotropium bromide is a bronchodilator used to manage asthma and chronic obstructive pulmonary disease (COPD). While it is not commonly associated with increasing blood pressure, the PN should still be aware of any potential side effects and monitor the client's blood pressure.
Choice C reason: Ethinyl estradiol/norethindrone is a combination oral contraceptive that contains estrogen and progestin. Estrogen can cause blood vessels to constrict, leading to an increase in blood pressure. The PN should educate the client about this potential side effect and monitor their blood pressure regularly.
Choice D reason: Pseudoephedrine is a decongestant that can cause vasoconstriction and increase blood pressure. It is important for the PN to inform the client about this potential side effect and monitor their blood pressure closely.
Choice E reason: Albuterol sulfate is a bronchodilator used to relieve asthma symptoms. While it can cause some cardiovascular side effects, such as increased heart rate, it is not typically associated with a significant increase in blood pressure. The PN should still monitor the client's blood pressure and be aware of any potential side effects.