A nurse is caring for a client who has benign prostate hyperplasia (BPH) and a new prescription for doxazosin IR. Which of the following actions should the nurse plan to take first?

Choice A rationale
Taking ibandronate immediately after a meal is incorrect because food and beverages can significantly decrease the absorption of ibandronate. It should be taken on an empty stomach at least 60 minutes before any food or drink.
Choice B rationale
Drinking 8 ounces of milk when taking ibandronate is incorrect because calcium in milk can interfere with the absorption of the medication. It should be taken with plain water only.
Choice C rationale
Taking ibandronate before bedtime is incorrect because the patient needs to remain upright for at least 60 minutes after taking the medication to prevent esophageal irritation.
Choice D rationale
Taking one tablet of ibandronate on the same date each month is correct. This ensures consistent dosing and helps maintain the medication’s effectiveness.

The nurse should first address the client’s elevated temperature followed by administering fluids.

So, the complete sentence would be: The nurse should first address the client’s elevated temperature followed by administering fluids.

Certainly! Let’s break down the situation and the rationale behind the priorities:

Elevated Temperature

The client’s temperature spiked significantly from 36.7°C (98.1°F) to 40.2°C (104.4°F) within a short period. This rapid increase is concerning for several reasons:

1. Risk of Hyperthermia: A temperature of 40.2°C is dangerously high and can lead to hyperthermia, which can cause damage to body tissues and organs if not promptly addressed.
2. Signs of Infection or Sepsis: Such a high fever could indicate a postoperative infection or sepsis, both of which require immediate attention.
3. Physiological Stress: Elevated temperatures increase metabolic demands, which can exacerbate other symptoms like tachycardia (high heart rate) and hypotension (low blood pressure).

Administering Fluids

After addressing the elevated temperature, the next priority is to administer fluids. Here’s why:

1. Hypotension (Low Blood Pressure): The client’s blood pressure dropped from 110/75 mm Hg to 90/60 mm Hg. This hypotension could be due to several factors, including dehydration, fever, or a systemic inflammatory response.
2. Tachycardia (High Heart Rate): The client’s heart rate increased from 65/min to 125/min. This could be a compensatory mechanism for the low blood pressure or a response to the fever. Administering fluids can help stabilize the blood pressure and reduce the heart rate.
3. Preventing Shock: Ensuring adequate fluid volume is crucial to prevent hypovolemic shock, which can occur if the body loses too much fluid or blood.

Immediate Actions Taken

The nurse already administered acetaminophen and applied ice packs to help reduce the fever, which are appropriate initial steps. However, continuous monitoring and additional interventions, such as fluid administration, are necessary to stabilize the client’s condition.

Summary

In summary, the nurse should first address the client’s elevated temperature to prevent potential complications from hyperthermia and then administer fluids to stabilize blood pressure and heart rate. This approach prioritizes the most immediate threats to the client’s health and ensures a comprehensive response to the symptoms presented.