A nurse is caring for a patient who has partial-thickness burns on 50% of his body and is receiving total parenteral nutrition.
The nurse should actively monitor the patient for which of the following?

Choice A rationale

Diltiazem is a calcium channel blocker used to treat high blood pressure and prevent chest pain (angina). It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart. The sustained-release tablets are designed to release the medication slowly in the body. Therefore, patients are advised to consume the medication in its entirety. Crushing, chewing, or breaking the tablet would cause too much of the drug to be released at one time.

Choice B rationale

While it’s generally a good idea to store medications in a cool, dry place, specific storage instructions for diltiazem sustained-release tablets are not typically emphasized. The focus is more on the method of consumption.

Choice C rationale

Grapefruit and grapefruit juice may interact with diltiazem and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Therefore, it’s not advisable to accompany the medication with grapefruit juice.

Choice D rationale

Diltiazem can be taken with or without food. If it upsets the patient’s stomach, it can be taken with food. However, it’s not a mandatory instruction that the medication must be administered during meals.

Choice A rationale:

Oxygen saturation is not provided in the exhibits, so there is no data available to evaluate if it indicates improvement in the client’s condition. While oxygen saturation is an important indicator of respiratory function and overall oxygenation status, its absence means it cannot be used to assess the client’s progress in this case.

Choice B rationale:

Hemoglobin levels decreased from 14 g/dL on postoperative day 1 to 10.5 g/dL on postoperative day 2. This decline in hemoglobin levels suggests that the client may be experiencing blood loss or anemia, which is not indicative of improvement. Generally, an improvement in the client’s condition would be reflected in stable or increasing hemoglobin levels rather than a decrease.

Choice C rationale:

Mental status is an important indicator of overall recovery and improvement. On postoperative day 2, the client is described as drowsy but alert to voice. This level of responsiveness indicates an improvement in mental status compared to what might be expected immediately post-surgery. A client who is drowsy but still responsive to verbal stimuli is showing signs of regaining consciousness and cognitive function, which is a positive sign of recovery.

Choice D rationale:

Urinary output is not provided in the exhibits, so there is no data available to assess if it indicates improvement. Urinary output is an important measure of kidney function and fluid status, but without specific data, it cannot be used to determine the client’s progress.

Choice E rationale:

The WBC count increased from 7,000/mm³ on day 1 to 8,500/mm³ on day 2, which is within the normal range and indicates a healthy immune response.