The nurse is preparing to administer an inhaled corticosteroid to a client. Which condition in the client's medical history should cause the nurse to monitor the client more closely while on this medication?

A. Administer protamine sulfate: Protamine sulfate is the specific antidote for heparin. It binds to heparin and neutralizes its anticoagulant effect, making it the most appropriate intervention to control active bleeding due to a heparin overdose. Rapid administration is critical to prevent further blood loss.

B. Transfuse platelets: Platelet transfusion is generally indicated for thrombocytopenia or platelet dysfunction, not for anticoagulation caused by heparin. Heparin-induced bleeding is due to inhibited clotting, not platelet deficiency.

C. Transfuse packed red blood cells: Packed red blood cells may be required if the client experiences significant blood loss, but they do not address the underlying anticoagulation caused by the heparin overdose. This intervention is supportive, not corrective.

D. Administer vitamin K: Vitamin K is the antidote for warfarin or vitamin K–dependent anticoagulant toxicity. It has no effect on heparin-induced anticoagulation and would not stop the bleeding in this scenario.

A. Client #1: A 45-year-old male with migraine, dehydration, and a history of hypertension could safely receive a calcium channel blocker if indicated for blood pressure management. No contraindications are present in his profile that would make the order unsafe.

B. Client #2: A 68-year-old with influenza and chronic stable angina may benefit from a calcium channel blocker to manage angina symptoms. There are no absolute contraindications based on his current condition or history.

C. Client #3: A 39-year-old post-spinal surgery with chronic hypertension could be prescribed a calcium channel blocker for blood pressure control. His surgical status does not contraindicate the use of this medication unless there are specific hemodynamic concerns.

D. Client #4: A 54-year-old with acute MI and a lisinopril allergy should raise concern because calcium channel blockers, particularly non-dihydropyridines (like verapamil or diltiazem), may interact with ACE inhibitors and affect cardiac function. Post-MI clients require careful selection of antihypertensive therapy.