A nurse is preparing to administer an amphotericin B lipid complex via intermittent IV bolus to a client who has infective endocarditis. Which of the following actions should the nurse take?

A. Dispose of the remaining medication while another nurse observes:
This is the correct choice. When a nurse administers a fraction of a tablet, it is not safe or appropriate to store the remaining portion for future use, even if another dose is scheduled. Hydromorphone tablets are meant to be taken whole, and cutting or breaking them can lead to inconsistent dosages. It's important to follow safe medication administration practices and dispose of the unused portion while another nurse observes, ensuring proper disposal.
B. Store the remaining half of the pill in the automated medication dispensing system:
This choice is incorrect. Storing a fraction of a tablet in the automated medication dispensing system is not appropriate. The system is designed for intact medications, and splitting tablets could compromise the accuracy and safety of future doses.
C. Place the remaining half of the pill in the unit-dose package:
This choice is incorrect. Placing a partial tablet back into a unit-dose package could lead to confusion and potential administration errors in the future. The medication packaging should reflect the correct and complete dosage as prescribed.
D. Return the remaining medication to the facility's pharmacy:
This choice is incorrect. Returning a partially used tablet to the pharmacy is not advisable, as the pharmacy cannot ensure the tablet's integrity or accurately verify its dosage. Medication storage and handling standards are in place to ensure patient safety, and using a fraction of a tablet may compromise those standards.

A. Increased blood pressure:
An elevated aPTT (activated partial thromboplastin time) suggests that the client is receiving heparin therapy. Heparin is an anticoagulant that prevents blood clotting. It's not likely to cause a significant increase in blood pressure directly. Changes in blood pressure may occur due to other factors, but they are not directly related to heparin therapy.
B. Decreased temperature:
Heparin administration does not typically have a direct effect on body temperature. Changes in body temperature might be due to other factors such as infection, but they are not a primary consideration when assessing the effects of heparin therapy.
C. Decreased respiratory rate:
Heparin administration is not known to directly affect respiratory rate. Changes in respiratory rate could be related to respiratory conditions, pain, or other factors unrelated to heparin therapy.
D. Increased pulse rate:
This is the correct choice. Heparin is known to affect the clotting process by inhibiting clot formation. An extended aPTT of 90 seconds indicates that the client's blood is taking longer to form clots than the normal range. This could lead to concerns about potential bleeding complications. Increased pulse rate could be an early sign of bleeding or decreased perfusion, as the body may attempt to compensate for reduced blood volume due to prolonged clotting times.