Question

The nurse notes that a client has been receiving hydromorphone every six hours for four days. Which assessment is most important for the nurse to complete?

a. Observe for edema around the ankles.
b. Auscultate the client's bowel sounds.
c. Count the apical and radial pulses simultaneously.
d. Measure the client's capillary glucose level.

Answer 1

The most important assessment for the nurse to complete is to measure the client's capillary glucose level due to the client receiving hydromorphone.

Step-by-step explanation:

The most important assessment for the nurse to complete in this case is to measure the client's capillary glucose level.

Hydromorphone is a potent opioid pain medication that can cause respiratory depression, which may lead to hypoglycemia. Measuring the client's capillary glucose level can help identify any potential hypoglycemic episodes and allow for appropriate intervention.

Monitoring for edema, auscultating bowel sounds, and counting pulses are important assessments, but they may not be directly related to the client's medication regimen in this scenario.