A nurse is preparing to administer pain medication to a postoperative client who had a total knee replacement and reports pain as 5 on a scale of 0 to 10. Which of the following PRN medications should the nurse plan to administer?

B) Sepsis: Propofol is an intravenous sedative-hypnotic agent commonly used for sedation in mechanically ventilated patients. While propofol itself does not directly cause sepsis, its use can increase the risk of sepsis-related complications, such as infection. Propofol is typically administered intravenously, and improper handling or contamination of equipment, including intravenous lines and medication vials, can introduce pathogens into the bloodstream, leading to bloodstream infections (sepsis). Additionally, prolonged use of propofol may suppress immune function, further increasing the susceptibility to infection. Therefore, the nurse should monitor the client for signs and symptoms of sepsis, such as fever, chills, hypotension, tachycardia, and altered mental status, as a potential complication of propofol administration.

A) Hypokalemia: Hypokalemia, or low potassium levels, is not a common complication directly associated with propofol administration. While electrolyte imbalances may occur in critically ill patients, especially those receiving mechanical ventilation, hypokalemia is more likely to result from other factors such as diuretic therapy, gastrointestinal losses, or inadequate potassium intake.

C) Urinary retention: Urinary retention is not a typical complication of propofol administration. While sedative medications like propofol can affect bladder function, causing urinary retention in some cases, it is not a commonly reported complication of propofol use in mechanically ventilated patients.

D) Hypoglycemia: Hypoglycemia, or low blood sugar levels, is a potential complication of propofol administration, particularly in critically ill patients who may have altered glucose metabolism. However, hypoglycemia is not as commonly associated with propofol use as sepsis-related complications. Close monitoring of blood glucose levels is essential when administering propofol, especially if the client has preexisting diabetes mellitus or other risk factors for hypoglycemia. However, sepsis is a more direct and significant complication associated with propofol administration in mechanically ventilated patients.

A) "Inject the medication into the lateral thigh": While the lateral thigh is a common site for subcutaneous injections, enoxaparin is typically administered in the abdomen. Instructing the client to inject into the lateral thigh may lead to incorrect administration. Therefore, this instruction is not appropriate for enoxaparin administration.

B) "Ensure that the air bubble remains in the syringe": This instruction is correct. Enoxaparin prefilled syringes usually come with an air bubble to help ensure the full dose is delivered. Instructing the client to keep the air bubble in the syringe helps prevent the loss of medication during administration, ensuring that the full dose is delivered subcutaneously.

C) "Release the skin fold before injecting the medication": Releasing the skin fold before injecting the medication helps ensure proper needle insertion into the subcutaneous tissue and facilitates medication absorption. This instruction is generally appropriate for subcutaneous injections but is not specific to enoxaparin administration.

D) "Rub the site after injecting the medication": Rubbing the injection site after administration is not recommended, as it can cause irritation and discomfort. Instead, instruct the client to gently press on the injection site without rubbing to help disperse the medication and minimize bruising or discomfort. Therefore, this instruction is not appropriate for enoxaparin administration.