Which laboratory value should the practical nurse (PN) monitor to determine if an antilipidemic medication is having the desired effect for the client?

Choice A reason: Pupils equal and reactive to light assess neurological status, not bronchodilator effectiveness. Bronchodilators, like albuterol, relax airway smooth muscles, improving breathing in emphysema. Pupil response is unrelated to respiratory function, making this choice irrelevant for evaluating the drug’s impact.

Choice B reason: Heart rate of 106 beats/minute may reflect a bronchodilator side effect, as beta-agonists stimulate cardiac beta receptors, causing tachycardia. However, it does not measure effectiveness, which is assessed by improved airway function, like respiratory rate, making this choice incorrect.

Choice C reason: Respiratory rate of 22 breaths/minute indicates bronchodilator effectiveness, as these drugs dilate airways, reducing work of breathing in emphysema. A normalized rate suggests improved airflow and oxygenation, directly reflecting the drug’s therapeutic action on bronchial smooth muscle relaxation.

Choice D reason: Urine output of 40 mL/hour monitors renal function, not bronchodilator efficacy. Bronchodilators target airway dilation, not fluid balance. This finding is unrelated to emphysema treatment or the drug’s respiratory effects, making it irrelevant for assessing medication effectiveness.

Choice A reason: Family history of hypertension is relevant for cardiovascular risk but less critical than smoking for estrogen therapy. Estrogens increase blood pressure slightly, but smoking directly amplifies thromboembolism risk, a major contraindication, making this choice secondary for immediate safety assessment.

Choice B reason: Soft lens use may cause discomfort with estrogens due to corneal changes, but this is a minor side effect. Thromboembolism risk, heightened by smoking, is far more severe, requiring priority assessment, as lens issues do not pose life-threatening risks.

Choice C reason: Sunlight exposure is unrelated to conjugated estrogens, which do not cause photosensitivity. Hormone therapy affects clotting and cardiovascular risk, not skin reactions to UV light, making this choice irrelevant for assessing safety before initiating estrogen treatment.

Choice D reason: Cigarette smoking history is critical, as smoking increases thromboembolism risk with conjugated estrogens, which promote clotting by altering coagulation factors. This risk is especially high in women over 35, necessitating smoking cessation or alternative therapies to prevent potentially fatal complications.