171) ANSWER

D) If client has ingested grapefruit juice with meals

RATIONALE

Grapefruit juice changes the metabolism of the calcium channel blocker drugs and leads to an increase in blood levels of the drug resulting serious signs and symptoms such as dysrhythmia, angina, heart block, bradycardia, and hypotension (option 4). Assessment of respiratory pattern may be important because of the toxicity, but does not address the primary problem directly (option 2). Assessment should focus on the cause. There is no direct relationship between altered body temperature and toxic levels of this drug (option 1). Weight gain is an adverse effect of this drug. The highest priority is insisting the client ingest this drug safely. Identification of the cause of the toxicity takes the highest priority (option 3). Apply knowledge of the primary cause of toxicity in calcium channel blockers.