A nurse is caring for a client and preparing to complete a medication reconciliation. Which of the following actions should the nurse complete first?

A. “Increased level of consciousness”: While theophylline can have some stimulant effects, an increased level of consciousness is not the primary therapeutic goal of this medication. Theophylline is used to treat respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), so its effectiveness is measured by improvement in respiratory symptoms.

B. “Decreased wheezing”: This is the correct answer. Theophylline is a bronchodilator, meaning it helps to open up the airways in the lungs. This can lead to a decrease in symptoms such as wheezing. Therefore, decreased wheezing is an indication that the medication is effective.

C. “Increased blood pressure”: Theophylline can potentially cause an increase in heart rate, which could lead to an increase in blood pressure. However, this is more likely to be a side effect of the medication rather than an indication of its effectiveness.

D. “Decreased urine output”: Theophylline does not typically affect urine output. Therefore, a decrease in urine output would not be an indication that the medication is effective.

A. “Document the updated list and send it to the pharmacy”: While this is an important step in the medication reconciliation process, it is not the first step. The nurse must first have a complete and accurate list of all the medications the client is currently taking.

B. “Compile a list of all medications the client is currently taking”: This is the first step in the medication reconciliation process. The nurse needs to know all the medications the client is currently taking, including prescription drugs, over-the-counter medications, herbal supplements, and any other substances. This list should include the name of each medication, the dose, the frequency, and the route of administration.

C. “Compare preadmission medications to current medications”: This is an important step in the medication reconciliation process, but it cannot be done until after the nurse has compiled a list of all medications the client is currently taking.

D. “Address any discrepancies between current medications and new prescriptions”: Addressing discrepancies is a crucial part of the medication reconciliation process, but it is not the first step. The nurse must first compile a list of all medications the client is currently taking, then compare this list to the client’s preadmission medications and any new prescriptions.