The practical nurse (PN) is assisting with the plan of care (POC) for a client with costochondritis who is now experiencing increased discomfort in breathing. The client receives a prescription for meloxicam. Which intervention should the PN include in the client’s POC?

Choice A reason: A neurological exam assesses brain function but does not directly address glipizide-related symptoms like confusion and blurred vision, which suggest hypoglycemia. Glipizide, a sulfonylurea, lowers blood glucose, and these symptoms are likely due to low glucose levels, making glucose testing more urgent than a neurological evaluation.

Choice B reason: Administering glucagon treats severe hypoglycemia but is premature without confirming low blood glucose. Glipizide increases insulin release, potentially causing hypoglycemia, but a fingerstick glucose test is needed first to verify the cause of symptoms. This choice is incorrect without diagnostic confirmation.

Choice C reason: Measuring vital signs provides general health data but does not specifically address confusion and blurred vision caused by glipizide-induced hypoglycemia. Low blood glucose is the likely cause, and testing glucose levels is more direct and urgent than monitoring vital signs, which are secondary in this context.

Choice D reason: Obtaining a fingerstick blood glucose is critical, as glipizide can cause hypoglycemia, leading to confusion and blurred vision. These symptoms result from insufficient glucose in the brain and eyes. Confirming low glucose guides immediate treatment, such as glucose administration, making this the most appropriate action.

Choice A reason: Ankle circumference monitors edema, which mannitol reduces by drawing fluid from tissues. However, this is secondary to urinary output, as mannitol’s primary action is diuresis, increasing urine production to reduce intracranial or intraocular pressure, making edema measurement less critical.

Choice B reason: Heart rate is relevant for overall monitoring but not the primary outcome for mannitol, which acts as an osmotic diuretic. Cardiovascular effects are secondary, and mannitol’s efficacy is better assessed by urine output, which directly reflects its diuretic mechanism.

Choice C reason: Dietary intake is unrelated to mannitol’s therapeutic effect. Mannitol pulls fluid into the bloodstream, increasing urine output, not influenced by diet. Monitoring intake may be relevant for other conditions, but it is not critical for assessing mannitol’s diuretic action.

Choice D reason: Urinary output is the most important outcome, as mannitol, an osmotic diuretic, increases urine production by drawing fluid into the renal tubules, reducing intracranial or intraocular pressure. Adequate output (e.g., >30 mL/hour) confirms efficacy, preventing fluid overload or renal complications.