A patient who has been taking opioids for several weeks tells the nurse, "The medication doesn't seem to work as well anymore." The nurse recognizes this as a sign of:

Choice A reason: "Antibiotics are administered to treat viral infections." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply. Antibiotics do not work against viruses, such as those that cause colds, flu, or COVID19. Taking antibiotics when they are not needed can cause harm and increase the risk of antibiotic resistance¹.

Choice B reason: "Bloody stools are expected while taking antibiotics." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Bloody stools are not a normal or expected side effect of antibiotics. They can indicate a serious condition, such as intestinal bleeding, ulcerative colitis, or Clostridioides difficile infection. C. diff is a type of bacteria that can cause severe diarrhea, abdominal pain, and bloody stools. It can occur when antibiotics disrupt the normal balance of bacteria in the gut and allow C. diff to grow and produce toxins. The nurse should instruct the client to report any signs of bloody stools or severe diarrhea to the health care provider immediately.

Choice C reason: "Take the entire course of antibiotics as prescribed." is a correct statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Taking the entire course of antibiotics as prescribed is important to ensure that the infection is completely treated and to prevent the bacteria from becoming resistant to the antibiotic. Stopping the antibiotic too soon or skipping doses can allow some bacteria to survive and multiply, which can cause the infection to come back or spread to other parts of the body. The nurse should also remind the client to follow the instructions on the medication label or the prescriber's order regarding the dosage, frequency, and duration of the antibiotic therapy.

Choice D reason: "Discontinue the medication when you feel better." is an incorrect statement for the nurse to make when providing teaching for a client who has a new prescription for an antibiotic. Discontinuing the medication when the client feels better is not advisable, as it can lead to incomplete treatment and antibiotic resistance. Feeling better does not mean that the infection is gone or that the bacteria are all killed. The client should continue to take the antibiotic until the end of the prescribed course, even if they have no symptoms or feel better. The nurse should also advise the client to contact the health care provider if they have any questions or concerns about the antibiotic or if they experience any side effects or allergic reactions.

Choice A reason: Vasodilation is not the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can cause vasodilation by inhibiting the muscarinic receptors on the blood vessels, which normally cause vasoconstriction. However, this effect is not significant or consistent, and it does not improve the symptoms of bradycardia, which is a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the blood pressure and the peripheral pulses of the patient after administering atropine.

Choice B reason: Bronchodilation is not the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can cause bronchodilation by inhibiting the muscarinic receptors on the bronchial smooth muscle, which normally cause bronchoconstriction. However, this effect is not relevant or beneficial for the patient with symptomatic bradycardia, who does not have any respiratory problems. The nurse should assess the respiratory rate and the breath sounds of the patient after administering atropine.

Choice C reason: Increase in heart rate is the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can increase the heart rate by inhibiting the muscarinic receptors on the sinoatrial node and the atrioventricular node, which normally slow down the heart rate. This effect is desirable and beneficial for the patient with symptomatic bradycardia, who has a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the electrocardiogram and the heart rate of the patient after administering atropine.

Choice D reason: Diuresis is not the primary therapeutic effect of atropine in this scenario. Atropine is a medication that blocks the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Atropine can cause diuresis by inhibiting the muscarinic receptors on the bladder, which normally promote urination. However, this effect is not important or helpful for the patient with symptomatic bradycardia, who does not have any urinary problems. The nurse should measure the urine output and the specific gravity of the patient after administering atropine.