An older adult client is being discharged after a myocardial infarction (MI) and receives a new prescription for atenolol. Which instruction is most important for the nurse to include in this client's teaching plan?

A. Chemical burn: Ketorolac is an NSAID used to manage pain and inflammation in the eye, but chemical burns require immediate irrigation and specialized treatment rather than simply addressing inflammation. Reviewing for chemical burns is not the key concern before administering ketorolac.

B. Foreign body: The presence of a foreign body in the eye would necessitate removal and possibly different treatment approaches. However, ketorolac would not be contraindicated solely because of a foreign body once it is addressed.

C. Corneal abrasion: Ketorolac should be used cautiously or avoided if there is a corneal abrasion because it can delay healing and increase the risk of corneal damage. Therefore, reviewing for a history of corneal abrasion is essential before administering this medication.

D. Radiation exposure: Radiation exposure to the eye would be managed differently, often requiring other supportive measures. It does not specifically contraindicate the use of ophthalmic ketorolac.

Blood glucose 218 mg/dL (12.1 mmol/L)

• Classification: Unrelated Finding

• Rationale: Minoxidil does not influence blood glucose levels. This elevated blood glucose is likely related to the patient’s known history of type 2 diabetes mellitus. It's not a side effect or intended therapeutic action of minoxidil.

Dizziness while sitting up

• Classification: Nontherapeutic Side Effect

• Rationale: Minoxidil is a vasodilator that can cause a rapid drop in blood pressure, particularly when changing positions (orthostatic hypotension). Dizziness is a common side effect due to decreased cerebral perfusion when blood pressure drops too quickly or too much.

Blood pressure 162/111 mm Hg

• Classification: Therapeutic Result

• Rationale: On admission, the patient’s BP was dangerously high at 203/166 mm Hg. A subsequent reading of 162/111 mm Hg shows a significant drop, indicating that minoxidil is having the desired therapeutic effect of lowering blood pressure, even though it's still above target.

Pain rated at 1 on a 0 to 10 scale

• Classification: Unrelated Finding

• Rationale: Minoxidil is not a pain medication and does not impact pain perception. A low pain score of 1 is likely due to an unrelated mild discomfort or pre-existing condition and has no connection to minoxidil's effects.

Urine output 600 mL

• Classification: Unrelated Finding

• Rationale: Minoxidil may cause fluid retention, but 600 mL urine output is within the normal range over a few hours (depending on timing and context). This measurement alone does not indicate a therapeutic or side effect of the drug, and without signs of oliguria or diuresis, it remains unrelated.