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?

A) "Call 911 if pain persists 30 minutes after taking one tablet": This instruction is not accurate and could potentially delay appropriate medical intervention for angina. Nitroglycerin sublingual tablets are rapid-acting vasodilators used to relieve acute angina symptoms. If chest pain persists after taking one tablet, the client should take another tablet after 5 minutes. If the pain persists after a total of three tablets, the client should seek emergency medical assistance.

B) "Place the tablet under the tongue until dissolved": This instruction is correct. Nitroglycerin sublingual tablets should be placed under the tongue and allowed to dissolve completely. Sublingual administration allows for rapid absorption of the medication into the bloodstream, providing quick relief of angina symptoms.

C) "Store the tablets in a refrigerator in a plastic container": This instruction is incorrect. Nitroglycerin sublingual tablets should be stored in their original container at room temperature, away from moisture and heat. Storing them in the refrigerator could alter their effectiveness.

D) "Take a tablet every 10 minutes until the pain subsides": This instruction is incorrect and potentially dangerous. Nitroglycerin sublingual tablets should be taken as directed by the healthcare provider or based on the client's angina management plan. Typically, the client should take one tablet at the onset of angina symptoms and repeat the dose every 5 minutes if the pain persists, up to a maximum of three tablets within 15 minutes. Taking a tablet every 10 minutes without regard to symptom relief or maximum dosage limits could lead to hypotension and other adverse effects.

A) Monitor the client for seizure activity: While diazepam is an anticonvulsant medication and may be used to prevent or treat seizures, it is unlikely to cause seizure activity as an adverse reaction when administered for moderate sedation. However, if the client has a history of seizures or is at risk for seizures, monitoring for seizure activity is essential. In the context of moderate sedation, the primary concern is related to the sedative effects of diazepam rather than seizure activity.

B) Check the client's urinary output: Monitoring urinary out’ut is important for assessing renal function and fluid balance, but it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve central nervous system depression, respiratory depression, or cardiovascular effects. Monitoring urinary output may be part of routine nursing care but is not specific to assessing adverse reactions to diazepam.

C) Monitor the client's oxygen saturation: This is the correct’action. Monitoring the client's oxygen saturation is essential for det’cting adverse reactions to diazepam, such as respiratory depression or hypoventilation. Diazepam can cause respiratory depression, especially when administered in higher doses or in combination with other sedative medications. Monitoring oxygen saturation allows the nurse to detect any signs of hypoxemia early and intervene promptly to ensure adequate oxygenation.

D) Auscultate the client's bowel sounds: While assessing bowel so’nds is important for evaluating gastrointestinal function, it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve effects on the central nervous system and respiratory system rather than gastrointestinal function. Monitoring bowel sounds may be part of routine nursing assessment but is not specific to assessing adverse reactions to diazepam.