A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dry mouth. Clonidine is an alpha-2 adrenergic agonist commonly used off-label to assist in managing withdrawal symptoms during opioid detoxification. Dry mouth is a common adverse effect of Clonidine due to its central nervous system effects on reducing sympathetic outflow. Option A) Diarrhea is less likely with Clonidine use and is not a common adverse effect associated with this medication. Option C) Insomnia is also less common with Clonidine use, as it is actually used for its sedative effects in some cases. Option D) Hypertension is a potential adverse effect of Clonidine; however, in this context of using Clonidine to maintain abstinence from opioids, the more immediate and common side effect to monitor for is dry mouth. Educationally, understanding the common adverse effects of medications is crucial for nurses to provide safe and effective care to their patients. By knowing the expected side effects, nurses can monitor patients appropriately, educate them on what to expect, and intervene if necessary to prevent complications.

Correct Answer: C

Rationale: In the context of a client receiving IV Dopamine for shock treatment, increased urine output (Option C) is the most indicative finding that the medication is effective. Dopamine is a vasopressor medication that works by increasing cardiac output and improving renal perfusion. The increase in urine output signifies improved renal blood flow and function, reflecting the medication's desired hemodynamic effect. Decreased blood pressure (Option B) would be an expected initial response to IV Dopamine due to its vasopressor effects, but solely relying on this parameter may not indicate the medication's overall effectiveness in treating shock. Increased heart rate (Option A) may occur as a compensatory mechanism in response to shock but is not a direct indicator of Dopamine's effectiveness. Decreased respiratory rate (Option D) is not directly related to the therapeutic action of Dopamine in treating shock. Monitoring respiratory rate is crucial for assessing respiratory function but is not a primary indicator of Dopamine's effectiveness in this context. Educationally, understanding the rationale behind monitoring urine output in clients receiving vasopressor therapy like Dopamine is essential in pharmacology. It reinforces the link between medication actions, physiological responses, and clinical monitoring, enhancing patient care and safety.

Correct Answer: A

Rationale: In pharmacology, the administration of medications requires adherence to specific guidelines to ensure patient safety and efficacy. In the case of Hydromorphone IV administration, the correct action is to administer the medication over 5 minutes (Option A). This is crucial because rapid IV administration of Hydromorphone can lead to serious adverse effects such as respiratory depression and hypotension. Administering the medication slowly allows for better control of its effects and reduces the risk of complications. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is an opioid antagonist used to reverse opioid overdose, not as a pre-treatment for opioid administration. Administering Naloxone without a specific indication can lead to unnecessary side effects. Option C, assessing the client's blood pressure prior to administration, is important in general patient care but is not directly related to the safe administration of Hydromorphone. While monitoring vital signs is essential, it is not the primary action to take before administering this medication. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect because Hydromorphone is specifically indicated for IV administration due to its rapid onset of action. Injecting it subcutaneously would delay its effects and potentially lead to inadequate pain relief. Educationally, this question highlights the importance of understanding the specific administration guidelines for different medications to ensure patient safety and optimal therapeutic outcomes. It reinforces the significance of proper drug administration techniques and the rationale behind them to prevent medication errors and adverse effects.

Correct Answer: B

Rationale: Pressing on the nasolacrimal duct, located near the inner corner of the eye, blocks the lacrimal punctum and prevents the medication from entering the systemic circulation. This technique helps to ensure the medication stays localized in the eye, enhancing its therapeutic effect while minimizing systemic side effects.

Correct Answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Therefore, choosing option D, Glaucoma, as the correct answer is essential for the client's safety and to prevent exacerbation of their eye condition.