An adolescent client has a new prescription for Clomipramine for OC. Which of the following instructions should the nurse include to minimize an adverse effect of this medication?

Correct Answer: A

Rationale: To minimize the adverse effect of photophobia associated with Clomipramine, the client should be advised to wear sunglasses when outdoors. Clomipramine is a tricyclic antidepressant (TCA) known to cause anticholinergic effects like photophobia, which can be reduced by protecting the eyes with sunglasses when exposed to bright light.

Correct Answer: C

Rationale: When administering eye drops, it is essential to instruct the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps ensure proper distribution of the medication and reduces the risk of potential adverse effects. Pressing on the inside corner of the eye is done to prevent systemic absorption, applying drops directly on the cornea can cause irritation, and wiping the eyes after application can lead to decreased effectiveness of the medication.

Correct Answer: D

Rationale: In this scenario, the priority finding to report to the provider is option D) Urine output of 200 mL in 8 hours. Furosemide is a diuretic that helps the body get rid of excess water and salt through urine. A low urine output could indicate decreased renal perfusion, which can be a sign of worsening heart failure or renal impairment. This finding needs prompt attention to prevent further complications. Option A) Weight loss of 1 kg in 24 hours could be expected with diuretic use, but it is not as concerning as a decreased urine output in this context. Option B) Blood pressure of 104/60 mm Hg is slightly low but may be a common side effect of diuretics and may not be a priority over decreased urine output. Option C) Potassium level of 3.5 mEq/L is within the normal range and not an immediate concern unless it drops further. Educationally, this question highlights the importance of recognizing priority assessments in clients taking diuretics for heart failure. Understanding the rationale behind prioritizing certain findings can help nurses provide timely and appropriate care to prevent complications in clients receiving diuretic therapy.

Correct Answer: B

Rationale: The correct answer is B) Remove the patch at bedtime each day. Nitroglycerin patches are typically removed at bedtime to allow for a nitrate-free interval, which helps prevent tolerance to the medication's effects. This timing also mimics the body's natural circadian rhythm, as nitroglycerin is often used to prevent angina episodes during the day when the heart's workload is higher. Option A) Apply the patch to a different site each day is incorrect because nitroglycerin patches are usually applied to the same general area (usually the upper torso or upper arm) to maintain consistent drug absorption. Option C) Apply the patch over an area with little or no hair is incorrect as hair does not significantly impact the absorption of the medication from the patch. Option D) Keep the patch on for 24 hours at a time is incorrect because nitroglycerin patches are typically worn for 12-14 hours to allow for a nitrate-free interval to prevent tolerance. Educationally, understanding the proper administration of nitroglycerin patches is crucial to ensure the medication's effectiveness and prevent adverse effects. Teaching patients about proper patch use can improve treatment outcomes and safety.

Correct Answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy. Epoetin Alfa stimulates red blood cell production, leading to an increase in hematocrit levels. Monitoring the hematocrit helps assess the response to therapy and ensures that the medication is effectively addressing the anemia.