A nurse is assisting with the care of a client.

The nurse is collecting data from the client.

Select words from the choices below to fill in each blank in the following sentence.

The nurse should identify that

_______

and

__________

indicate manifestations of borderline personality disorder.

A. "I should limit my intake of leafy green vegetables.": Limiting leafy green vegetables is associated with warfarin therapy because of their vitamin K content. It is not relevant to metoprolol, which primarily affects the cardiovascular system and does not interact significantly with dietary vitamin K.

B. "I may experience loss of taste.": Loss of taste is not a common side effect of metoprolol. Metoprolol is more associated with cardiovascular side effects such as bradycardia, hypotension, and dizziness rather than alterations in taste perception.

C. "I need to be careful when standing up from bed.": This is correct because metoprolol can cause orthostatic hypotension, leading to dizziness or lightheadedness upon standing. Clients are advised to rise slowly from a lying or seated position to reduce the risk of falls and fainting.

D. "I should expect some weight loss.": Metoprolol is more commonly associated with weight gain or no significant weight change rather than weight loss. Clients taking beta-blockers sometimes experience fluid retention or a slowed metabolism, leading to modest weight gain.

• Initiate a power of attorney for health care document: Nurses do not initiate or create legal documents like a power of attorney. The client must initiate this, often with legal assistance if needed.
• Provide the client with written information about advance directives: It is the nurse’s responsibility to ensure the client receives clear, written information about advance directives, including explanations of living wills, DNR orders, and medical power of attorney documents.
• Instruct the client that an advance directive is a legal document and must be honored by care providers: Nurses reinforce that advance directives are legally binding documents. They ensure the client's wishes are respected by the healthcare team throughout their care.
• Communicate advance directives status via the medical record and shift report: Once a client’s advance directive status is known, it must be accurately documented and communicated to all healthcare providers to ensure continuity and adherence to the client’s wishes.
• Document that the provider discussed do-not-resuscitate status with the client: Nurses are responsible for documenting that the conversation regarding DNR status occurred, including who had the conversation and the client's stated wishes, even though the actual discussion is led by the provider.
• Inform the client that an advance directive discontinues further care: Advance directives do not mean that all care is discontinued. Clients can still receive comfort, palliative, or supportive treatments based on their wishes outlined in the directive.