A nu’se is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take to minimize bleeding following the injection?

A) Extravasation: Extravasation, or the leaking of IV medication into surrounding tissues, is a potential complication of IV therapy. However, it does not indicate a need to increase the rate of dopamine infusion. Instead, the priority is to stop the infusion, assess the site for damage, and provide appropriate interventions to minimize tissue injury.

B) Hypotension: Hypotension, or low blood pressure, is a common indication for administering dopamine in septic shock to improve cardiac output and increase blood pressure. If the client's blood pressure remains low despite the’current rate of dopamine infusion, it may be necessary to increase the infusion rate to achieve the desired therapeutic effect and improve perfusion to vital organs. Therefore, hypotension is the correct finding that indicates the need to increase the rate of infusion.

C) Headache: While headache can occur as a side effect of dopamine infusion, it is not typically an indication to increase the infusion rate. Headache may warrant further assessment and management, but it does not directly correlate with the need for a higher dose of dopamine.

D) Chest pain: Chest pain may occur as a side effect of dopamine infusion or could be indicative of other cardiac or pulmonary issues. However, like headache, it is not a specific indicator for increasing the rate of dopamine infusion. Further assessment and appropriate interventions are needed to address chest pain, but it does not directly relate to the need for a higher infusion rate of dopamine.

A) Digoxin and levothyroxine: Digoxin is a cardiac glycoside used to treat heart failure and atrial fibrillation, while levothyroxine is a thyroid hormone replacement medication used to treat hypothyroidism. While both medications have potential side effects, hearing loss is not typically associated with either digoxin or levothyroxine. Therefore, monitoring for hearing loss related to a medication interaction is not a priority for clients taking digoxin and levothyroxine.

B) Losartan and atorvastatin: Losartan is an angiotensin II receptor blocker used to treat hypertension, while atorvastatin is a statin medication used to lower cholesterol levels. Hearing loss is not a known side effect of either losartan or atorvastatin, nor is there evidence of an interaction between these medications that would increase the risk of hearing loss. Therefore, monitoring for hearing loss related to a medication interaction is not indicated for clients taking losartan and atorvastatin.

C) Propranolol and raloxifene: Propranolol is a beta-blocker used to treat hypertension, angina, and other cardiovascular conditions, while raloxifene is a selective estrogen receptor modulator used to prevent and treat osteoporosis in postmenopausal women. Neither propranolol nor raloxifene is associated with hearing loss as a common side effect. Additionally, there is no known interaction between propranolol and raloxifene that would increase the risk of hearing loss. Therefore, monitoring for hearing loss related to a medication interaction is not necessary for clients taking propranolol and raloxifene.

D) Furosemide and amikacin: Furosemide is a loop diuretic that is commonly used to treat fluid overload conditions such as heart failure and edema. Amikacin is an aminoglycoside antibiotic used to treat bacterial infections. Both furosemide and amikacin have the potential to cause ototoxicity, which can manifest as hearing loss or tinnitus. When administered concurrently, especially at higher doses or for prolonged durations, the risk of ototoxicity may increase due to additive or synergistic effects on the inner ear structures. Therefore, the nurse should monitor clients receiving both furosemide and amikacin for signs of hearing loss, such as changes in hearing acuity or tinnitus, and promptly report any concerns to the healthcare provider for further evaluation and management.