Choice A rationale

Sildenafil, commonly known as Viagra, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. One of the side effects of sildenafil is visual changes. These changes can be temporary or long-lasting, and can potentially be a sign of a serious condition known as non-arteritic anterior ischemic optic neuropathy (NAION), which can lead to permanent vision loss. Therefore, it is crucial for the client to report these symptoms to the healthcare provider immediately for further evaluation and management.

Choice B rationale

While eye drops can be used to treat various eye conditions, they are not typically used to address visual changes caused by sildenafil. Therefore, instilling prescribed eye drops would not be the appropriate response in this situation.

Choice C rationale

Wearing dark glasses when outside can help protect the eyes from sun damage, but it would not address the underlying issue of visual changes caused by sildenafil. Therefore, this would not be the appropriate instruction for the practical nurse to give to the client.

Choice D rationale

The Amsler grid tool is used to detect vision problems resulting from damage to the macula (the central part of the retina) or the optic nerve. However, this tool would not be useful in this context as the visual changes are a side effect of sildenafil. Therefore, monitoring for visual changes each morning using an Amsler grid tool would not be the appropriate instruction for the practical nurse to give to the client.

Choice A rationale
Heart rate is an important vital sign to monitor in patients, but it is not the primary outcome
data to prioritize when administering a 20% mannitol intravenous (IV) solution. Mannitol is a diuretic that works by increasing the amount of urine produced. Therefore, while heart rate can be affected by fluid balance changes, it is not the most directly relevant outcome to monitor in this context.
Choice B rationale
Ankle circumference could be an indicator of peripheral edema, which might suggest fluid
overload or poor kidney function. However, in the context of mannitol administration, which is a diuretic and would be expected to decrease fluid overload, ankle circumference is not the primary outcome to monitor.
Choice C rationale
Urinary output is the correct answer. Mannitol is an osmotic diuretic that increases urine
production. It is used to reduce intracranial and intraocular pressure by drawing water out of tissues and into the bloodstream, from where it can be excreted by the kidneys. Therefore, urinary output is the most direct measure of its effectiveness and is the key outcome that should be monitored.
Choice D rationale
Dietary intake is always important to monitor in patients, especially those receiving IV
therapy, as it can impact electrolyte balance and overall health status. However, it is not the primary outcome to monitor when administering mannitol.