The practical nurse (PN) is checking the insulin dose drawn up by another PN and notes that the amount of insulin is 2 units more than the amount indicated for the glucose level written on the client’s medication record. Which action should the PN take?

Choice A reason: Digoxin toxicity can cause visual disturbances, like seeing yellow halos, due to its effect on retinal cone cells. The client’s comment about a yellow uniform suggests this side effect. Evaluating for toxicity, including checking serum digoxin levels, is critical, as toxicity can lead to life-threatening arrhythmias.

Choice B reason: Withholding furosemide and forcing fluids is inappropriate, as the client’s visual symptom points to digoxin toxicity, not furosemide-related issues. Furosemide causes diuresis, but no evidence suggests dehydration here. This choice does not address the likely digoxin-induced visual disturbance.

Choice C reason: Assuming the client is joking ignores a potential digoxin toxicity symptom. Visual changes, like yellow-tinted vision, are serious and require investigation, not dismissal. Administering medications without evaluation risks exacerbating toxicity, making this choice unsafe and incorrect.

Choice D reason: Additional potassium-rich foods are unnecessary, as the client is already receiving potassium chloride. The visual symptom suggests digoxin toxicity, not hypokalemia. Potassium levels may influence digoxin toxicity, but the priority is evaluating digoxin’s effects, not dietary intervention.

Choice A reason: Tetracycline causes photosensitivity, increasing UV-induced skin damage risk due to its accumulation in skin cells, triggering photochemical reactions. Protecting skin with sunblock or clothing prevents severe sunburn or rash, making this critical instruction for safe use during chlamydia treatment.

Choice B reason: Taking tetracycline with meals or milk reduces absorption, as calcium and magnesium bind the drug, forming insoluble complexes. This decreases efficacy, making it incorrect. Tetracycline should be taken on an empty stomach to ensure optimal bioavailability for infection treatment.

Choice C reason: Grapefruit juice affects drugs metabolized by CYP3A4, not tetracycline, which is not significantly influenced by this enzyme. This instruction is irrelevant, as tetracycline’s pharmacokinetics are unaffected by grapefruit, making it unnecessary for managing chlamydia treatment.

Choice D reason: Wearing tampons during menses is unrelated to tetracycline use. The drug treats bacterial infections, not menstrual management, and has no gynecological implications requiring tampon use. This choice is irrelevant to the medication’s administration or side effect profile.