Client who was admitted 3 days ago for a bowel obstruction...

client who was admitted 3 days ago for a bowel obstruction has a liter of lactated Ringers with potasslum charide (KC) 20 mEy infusing, The client has been recelving selegling for depression. When the ellent reports experiencing a severe headache, the nurse obtains a blood pressure of 200/110 mm Hg. Which action(s) should the nurse take? Select all that apply. A Measure hourly urinary ouipur. B Notly healthcare provider of dents findings. C Withhold the next dose of selegline. D Monitor blood pressure and pulse every 15 minutes. E Discontinue the IV infusion.

Transcript

00:01 So in this case, which action should a nurse take about this client? so in this case, we all we know about this client is that the client has a blood pressure of 1 ,20 -10 millimeter mercury.

00:27 So this is obviously we call a hypertensive crisis.

00:40 So the client is also receiving sledgelluline.

00:43 This is a inhibitor for m -a -o -i for the mono -amine oxidase.

01:05 And the ibupil contain potassium chloride.

01:10 So the nurse should first of all notify the health care provider of the client's finding.

01:30 So a hypertensive crisis is a medical emergency.

01:33 So obviously the healthcare provider must be notified immediately.

01:37 So the immediate notification of the health care provider is critical to initiate the treatment.

01:44 Now, other options such as c, withhold the next dose of seliginin.

01:50 Selegin as a maoi, a monoamine oxidase inhibitor can cause hypertensive crisis if the client continue to consume some tyramine containing food or interact with certain medication.

02:08 So this is also a very important step because already the client started to show the hypertensive crisis.

02:18 So any medication that could be a possible cause must be discontinued.

02:23 So withhold the next dose of this medication.

02:40 Because this medication can cause heart -tensive crisis combined with other medication or certain food...

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