The nurse is caring for a client who is taking metformin (Glucophage) for hyperglycemia prior to admission. The nurse would question the following order for this client:

Choice A reason: Allergy is an immune mediated reaction to a substance that causes symptoms such as rash, itching, swelling, or anaphylaxis. It is not related to the duration or effectiveness of the medication. The patient does not report any signs of allergy to the opioids.

Choice B reason: Addiction is a chronic and compulsive disorder that involves seeking and using a substance despite harmful consequences. It is characterized by loss of control, craving, and impaired functioning. The patient does not show any signs of addiction to the opioids, such as increasing the dose, obtaining the medication illegally, or neglecting other responsibilities.

Choice C reason: Withdrawal is a syndrome that occurs when a substance is abruptly discontinued or reduced after prolonged use. It causes physical and psychological symptoms such as anxiety, agitation, sweating, nausea, or tremors. The patient does not experience any signs of withdrawal from the opioids, as they are still taking the medication as prescribed.

Choice D reason: Tolerance is a phenomenon that occurs when a substance loses its effectiveness over time due to repeated exposure. It requires higher doses or more frequent administration to achieve the same effect. The patient reports a sign of tolerance to the opioids, as they feel that the medication does not work as well anymore. The nurse should assess the patient's pain level, monitor the opioid dose, and consult with the prescriber about possible adjustments or alternatives.

Choice A reason: Advise the client to avoid highfiber foods with the medication is not an appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix does not interact with highfiber foods or affect the digestion directly. Highfiber foods can actually help prevent or treat constipation, which can be a side effect of Lasix. The nurse should encourage the client to eat a balanced and nutritious diet, unless they have any dietary restrictions or allergies.

Choice B reason: Encourage the client to consume a potassium rich diet is not an appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can also cause the loss of potassium in the urine, which can lead to hypokalemia, a condition that causes muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should monitor the serum potassium level and administer potassium supplements or potassiumsparing diuretics as prescribed to prevent hypokalemia. Consuming a potassium rich diet may not be sufficient or safe to correct the potassium imbalance caused by Lasix, especially in clients with kidney impairment or other medications that affect the potassium level.

Choice C reason: Assess the client’s respiratory rate and oxygen saturation is the most appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can help reduce the fluid overload and congestion in the lungs, which can cause shortness of breath, difficulty breathing, fatigue, and low oxygen levels in clients with heart failure. The nurse should assess the client’s respiratory rate and oxygen saturation to evaluate the severity of the pulmonary edema and the effectiveness of the Lasix therapy. The nurse should also monitor the client’s vital signs, fluid intake and output, and weight to ensure adequate fluid balance and hemodynamic stability.

Choice D reason: Instruct the client to increase fluid intake to prevent dehydration is not an appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can cause dehydration, which can lead to symptoms such as thirst, dry mouth, dark urine, and fatigue. However, increasing fluid intake to prevent dehydration can worsen the fluid overload and congestion in the lungs, which can cause shortness of breath, difficulty breathing, fatigue, and low oxygen levels in clients with heart failure. The nurse should advise the client to drink enough fluids to maintain hydration, but not to exceed the prescribed fluid restriction, which is usually around 1.52 liters per day. The nurse should also educate the client about the signs and symptoms of dehydration and fluid overload, and when to seek medical attention.