A patient who is taking a potassium-wasting diuretic for the treatment of hypertension reports generalized weakness. Which action is appropriate for the nurse to take?

Choice A reason: Hypoglycemia typically presents with symptoms such as sweating, trembling, hunger, confusion, and in severe cases, loss of consciousness. The patient's symptoms of sudden right-sided weakness and difficulty speaking are more consistent with a neurological event rather than low blood sugar levels.

Choice B reason: Hemorrhagic stroke involves bleeding within the brain. Although it can present with similar symptoms to ischemic stroke, the diagnostic tests indicate no evidence of hemorrhage. This makes a hemorrhagic stroke less likely.

Choice C reason: Ischemic stroke occurs when a blood clot blocks a blood vessel in the brain, leading to reduced blood flow and oxygen to a part of the brain. The patient's symptoms of sudden right-sided weakness and expressive aphasia are classic signs of an ischemic stroke, and the absence of hemorrhage on the head CT scan supports this diagnosis.

Choice D reason: Multiple sclerosis (MS) is a chronic, progressive disease that affects the central nervous system. It usually presents with episodic neurological symptoms rather than the sudden onset seen in this patient. MS symptoms develop over time and can vary widely, whereas the patient's acute presentation is more indicative of a stroke.

Choice A reason: Checking the patient's temperature is important for assessing the severity of the pneumonia and monitoring for fever, but it is not the priority action before administering the first dose of vancomycin.

Choice B reason: Obtaining sputum cultures is the priority action because it allows for the identification of the causative organism and determination of its antibiotic susceptibility. This helps ensure that the prescribed antibiotic is appropriate for the patient's infection. Cultures should be obtained before starting antibiotic therapy to avoid interference with culture results.

Choice C reason: Checking the patient's blood pressure is important for overall patient assessment and monitoring, especially considering potential side effects of vancomycin. However, it is not the primary action needed before the first dose of the antibiotic.

Choice D reason: Drawing a blood specimen to evaluate the white blood cell count is useful for assessing the severity of the infection and the patient's immune response. However, this can be done after obtaining the sputum cultures and is not the immediate priority before administering the antibiotic.