A nurse in an acute care facility is collecting data from a client who has received the meningococcal conjugate vaccine.
The nurse should monitor the client for which of the following findings as an adverse effect of the vaccine?

Choice A rationale:

Renal excretion time slows for medication. As people age, kidney function gradually decreases, which slows the excretion of medications. This can lead to increased levels of the drug in the body, which can increase the risk of side effects.

Choice B rationale:

Hepatic enzymes do not process medications more rapidly in older adults. In fact, liver function also decreases with age, which can slow the metabolism of medications.

Choice C rationale:

Brain receptors do not become less sensitive to medications in older adults. The sensitivity of brain receptors to medications can vary widely and is not necessarily related to age.

Choice D rationale:

Gastric emptying rate does not increase with age. On the contrary, it often slows down, which can affect the absorption of some medications.

Choice A rationale:

An apical pulse of 54/min is below the normal range for adults. Digoxin, a cardiac medication, can lower the heart rate. Therefore, it’s crucial to hold the medication if the resting pulse for an adult is less than 60 bpm. This is to prevent further lowering of the heart rate which could lead to bradycardia, a potentially dangerous condition.

Choice B rationale:

A respiratory rate of 14/min is within the normal adult range of 12-20 breaths per minute. This would not be a reason to withhold digoxin.

Choice C rationale:

A blood pressure (BP) of 179/89 mm Hg indicates hypertension, which is not a direct contraindication for digoxin. However, it’s important to monitor BP levels in clients taking digoxin as the medication can affect blood pressure.

Choice D rationale:

A temperature of 37.8° C (100° F) is slightly elevated but would not be a reason to withhold digoxin unless it’s indicative of an underlying infection that needs to be addressed first.