Exhibits

For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client's first dose of captopril.

Choice A rationale: Crushing ciprofloxacin tablets may interfere with their efficacy, and it is generally not recommended to alter the dosage form without consulting a healthcare provider.

Choice B rationale: Ciprofloxacin may cause joint aches and pains, but using non-steroidal anti-inflammatory drugs (NSAIDs) is generally not advised as they can interact with the medication and increase the risk of adverse effects.
Choice C rationale: Ciprofloxacin is associated with the risk of tendonitis and tendon rupture. Therefore, any tendon pain or swelling should be reported immediately to the healthcare provider.
Choice D rationale: Increasing fluid intake while taking ciprofloxacin can help prevent crystalluria, a potential side effect of the medication.
Choice E rationale: Ciprofloxacin can make the skin more sensitive to sunlight, leading to an increased risk of sunburn. Patients should limit exposure to sunlight and avoid tanning beds while taking this medication.

Choice A rationale: Administering the dose of labetalol without further assessment may not be appropriate in this situation. The client's heart rate is 48 beats/minute, which is considered bradycardia (heart rate below the normal range of 60-100 beats/minute). Bradycardia can be a potential adverse effect of labetalol, a beta-blocker. Moreover, the client's blood pressure is elevated at 150/90 mm Hg, indicating that the hypertension is not well controlled. Administering the dose without addressing the bradycardia or elevated blood pressure could potentially exacerbate these issues.

Choice B rationale: Withholding the scheduled dose of labetalol is the most appropriate action in this scenario. The client's heart rate of 48 beats/minute is considered bradycardia, which may be a side effect of labetalol or indicative of an underlying issue. Additionally, the client's blood

pressure is elevated, indicating inadequate control of hypertension. Bradycardia can reduce cardiac output and may lead to further complications. Notifying the healthcare provider is essential to obtain further instructions and address the client's bradycardia and hypertension before administering the medication.

Choice C rationale: While telemetry monitoring is appropriate for clients with certain cardiac conditions or when changes in heart rate need close observation, it may not be the most urgent action in this situation. The client's bradycardia and elevated blood pressure are concerning and require immediate attention. Telemetry monitoring may be considered later, but it does not address the immediate need to withhold the medication and seek guidance from the healthcare provider.

Choice D rationale: Orthostatic hypotension refers to a drop in blood pressure when changing positions, such as from lying down to standing up. While orthostatic hypotension is a valid concern for clients taking antihypertensive medications, it is not the primary issue in this scenario. The client's heart rate is 48 beats/minute, indicating bradycardia and the blood pressure is elevated at 150/90 mm Hg, suggesting uncontrolled hypertension. These are the main concerns that require immediate attention and further assessment before administering the labetalol dose.