A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?

The nurse should include in the teaching that hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic commonly used to treat hypertension (high blood pressure). While it is effective in reducing blood pressure, it can sometimes cause adverse effects on blood glucose levels, particularly in individuals with diabetes mellitus.

Hydrochlorothiazide can cause an increase in blood glucose levels by reducing insulin sensitivity, leading to potential hyperglycemia (high blood sugar) in some individuals. Clients with diabetes should closely monitor their blood glucose levels while taking hydrochlorothiazide and inform their healthcare provider if they notice significant changes.

Let's go through the other options:

A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide": This statement is not accurate. Hydrochlorothiazide does not directly affect the accuracy of blood glucose monitoring. However, it is essential for clients with diabetes to be aware of the potential impact of hydrochlorothiazide on their blood glucose levels.

B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide": Hydrochlorothiazide can potentially elevate blood glucose levels, which may require adjustments in diabetes management, including insulin dosage. However, it is not accurate to state that all clients will need to decrease their insulin dosage while taking hydrochlorothiazide. Each client's response to the medication may vary, and adjustments to diabetes medications should be made under the guidance of their healthcare provider based on individual blood glucose monitoring.

D. "Reducing sodium in your diet can help control your blood glucose while taking hydrochlorothiazide": While reducing sodium in the diet is generally a beneficial recommendation for individuals with hypertension, it is not directly related to controlling blood glucose levels in clients with diabetes. The primary focus for individuals with diabetes taking hydrochlorothiazide should be on monitoring blood glucose levels and working with their healthcare provider to manage any changes related to the medication.

When a medication error occurs, the nurse should report the incident to the nurse manager or appropriate supervisor. It is essential to follow the facility's policies and procedures for reporting and managing medication errors. Prompt reporting allows for appropriate investigation, documentation, and implementation of necessary measures to prevent future errors.

Documenting that the pharmacy sent the incorrect medication (B) is not appropriate in this situation, as it does not address the nurse's role and responsibility in the error. Reporting the incident is the primary action required.

Contacting the provider to change the client's prescription (C) is not necessary in this case, as the error was related to the medication selection during administration, not an issue with the prescription itself.

Placing the unwrapped celecoxib back into the AMDS (D) is not appropriate. Once a medication has been removed from its packaging or container, it should not be returned to the dispensing system. Additionally, since it was the wrong medication for the client, it should not be administered.

Therefore, the nurse should primarily report the incident to the nurse manager or appropriate supervisor to ensure appropriate handling of the medication error.