The practical nurse (PN) notes that a client who is receiving continuous nonsteroidal antiinflammatory drug (NSAID) therapy has a new prescription for esomeprazole. The PN tells the client that the new medication should reduce the client's risk for which complication?

A. Call bell, side rails, bed in low position, and ambulation aids: These are safety measures important to prevent falls, but they do not reflect the client’s immediate postoperative neurovascular status or potential complications.

B. Clear lung sounds, CPM (continuous passive motion) on: Monitoring lung sounds and CPM use is part of routine postoperative care. While important, these findings are not as urgent as neurovascular assessments in detecting limb compromise.

C. Paresthesia, paralysis, pedal pulses, pallor, and pain: Documenting changes in sensation, motor function, circulation, or severe pain helps detect complications such as compartment syndrome, vascular compromise, or nerve injury, which require immediate intervention.

D. Blood pressure 138/88, pain scale 7, and respirations 22: Vital signs and pain rating provide useful information on overall status, but they do not specifically address the neurovascular integrity of the operative limb, which is the highest-priority assessment after knee replacement.

A. Perform a daily whisper test of the client's hearing to detect symptoms of ototoxicity: Ototoxicity is associated with certain antibiotics and loop diuretics, not tramadol. Hearing assessment is not a priority intervention for this client receiving tramadol.

B. Examine the client for stomatitis and erosion of tooth enamel: Stomatitis and tooth enamel erosion are linked to chronic use of acidic medications or poor oral hygiene, not tramadol. These assessments are unrelated to the prescribed opioid therapy for pain.

C. Ensure peak and trough serum levels are collected with the third medication dose: Peak and trough monitoring is relevant for medications with narrow therapeutic windows, such as aminoglycosides or anticonvulsants, not tramadol. Routine serum monitoring is unnecessary.

D. Implement ongoing assessments for signs of shallow or slow breathing: Tramadol is an opioid analgesic that can cause respiratory depression. Monitoring for shallow, slow, or irregular breathing is essential to ensure client safety, especially in clients experiencing pain that may already alter normal respiratory patterns.