A nurse is preparing to administer diclofenac to a client who has chronic bursitis.
Which of the following actions should the nurse take?

Choice A rationale

Pseudoephedrine is a sympathomimetic agent that primarily acts as a vasoconstrictor and bronchodilator. It does not directly affect kidney function to cause polyuria. In fact, due to its vasoconstrictive properties, it could theoretically decrease renal blood flow, although this is not a common or expected adverse effect leading to increased urine output.

Choice B rationale

Pseudoephedrine's primary mechanism of action involves stimulating alpha- and beta-adrenergic receptors. It does not have a known effect on appetite regulation; it is not typically associated with either increased or decreased appetite. Therefore, an increased appetite is not an expected adverse effect of this medication.

Choice C rationale

Pseudoephedrine is a sympathomimetic drug that stimulates adrenergic receptors, leading to effects similar to sympathetic nervous system activation. This stimulation typically results in tachycardia, not bradycardia. It increases heart rate and contractility, which can be problematic for individuals with pre-existing cardiovascular conditions.

Choice D rationale

As a sympathomimetic, pseudoephedrine causes vasoconstriction by stimulating alpha-1 adrenergic receptors in the arterioles. This widespread vasoconstriction leads to an increase in peripheral vascular resistance, which in turn can elevate blood pressure. Therefore, hypertension is a common and important adverse effect to monitor for, especially in individuals with pre-existing hypertension.

Choice A rationale

Notifying the client's provider is the first and most critical step. The provider needs to be immediately informed of the medication error, as they are responsible for assessing the client's current condition, determining the potential impact of the incorrect medication, and ordering necessary interventions or monitoring.

Choice B rationale

Completing an incident report is important for quality improvement and safety, but it should be done after the immediate safety of the client has been addressed and the provider has been notified. The priority is always patient well-being and clinical management.

Choice C rationale

While reviewing possible adverse effects is part of understanding the situation, the nurse's primary action should be to involve the prescribing authority. The provider can then provide specific guidance for monitoring and management based on the client's individual health status.

Choice D rationale

Administering clonazepam as prescribed should be done once the immediate risk from the clonidine has been assessed and managed, and the provider has given appropriate instructions. Giving the correct medication immediately without assessing the impact of the error could be premature or harmful.