The practical nurse (PN) is caring for a client receiving a prescription for paroxetine who suddenly exhibits restlessness, tachycardia, fever, and elevated blood pressure. Which action should the PN implement first?

Choice A reason: Conferring with the charge nurse is unnecessary, as a blood pressure of 120/72 mm Hg is within normal range for a client on maintenance antihypertensive therapy. Maintenance doses prevent hypertension recurrence, and this reading does not indicate a need to alter the schedule.

Choice B reason: Advising the client to report rising blood pressure symptoms is general education, not an action addressing the current situation. The blood pressure is normal, and the maintenance dose is indicated to sustain control, making this choice irrelevant for immediate action.

Choice C reason: Withholding the medication and rechecking in an hour risks blood pressure spikes, as maintenance therapy prevents hypertension. A normal reading of 120/72 mm Hg indicates effective control, and stopping the dose could destabilize the client’s condition, making this choice inappropriate.

Choice D reason: Administering the scheduled antihypertensive dose is correct, as 120/72 mm Hg indicates effective blood pressure control. Maintenance therapy sustains normotension by regulating vascular tone or fluid balance, preventing hypertensive episodes, ensuring cardiovascular stability, and aligning with the prescription’s intent.

Choice A reason: The cost of medications, while a practical concern, does not indicate a need to assess the prescription’s safety or appropriateness. It reflects financial issues, not a clinical discrepancy. The PN should address cost concerns separately, but this does not warrant immediate prescription review.

Choice B reason: Frustration with daily pill-taking reflects emotional fatigue, not a clinical issue requiring prescription assessment. It may prompt adherence counseling, but it does not suggest errors in the prescription itself, such as incorrect medication or dosage, making this choice incorrect.

Choice C reason: Taking pills at 8:00 am at home versus 9:00 am in the hospital is a minor timing difference, not necessitating prescription review. Hospital schedules often differ, and this does not indicate a safety concern or error in the medication order.

Choice D reason: A new, unfamiliar pill raises concerns about potential prescription errors, allergies, or inappropriate medication. The PN must verify the prescription against the client’s history and medical record to ensure safety, as unfamiliarity may indicate a mistake or new therapy requiring confirmation.