A client is receiving intravenous octreotide for acute variceal bleeding. Which assessment plan best addresses important adverse effects of this therapy?
1Monitor temperature, leukocyte count, and abdominal girth for evidence of infection and worsening ascites.
2Monitor peripheral pulses, capillary refill, and limb temperature for evidence of acute arterial vasospasm.
3Monitor urine output, serum creatinine, and daily weight for evidence of sodium retention and renal failure.
4Monitor heart rate and rhythm, blood glucose, and right-upper-quadrant symptoms associated with biliary complications.✓ Correct answer
Explanation
Octreotide can cause bradycardia, arrhythmias, or conduction abnormalities and can alter glucose regulation, producing either hypoglycemia or hyperglycemia. It also reduces gallbladder contractility and bile secretion, so right-upper-quadrant pain or other signs of biliary complications require evaluation. The other plans do not target the principal labeled adverse effects of octreotide.
Clinical reasoning Octreotide suppresses several gastrointestinal and endocrine hormones. Its clinically important monitoring cluster includes cardiac rate and conduction, glucose regulation, and biliary complications.
Decision rule During intravenous octreotide therapy, monitor heart rate and rhythm and blood glucose. Assess new right-upper-quadrant pain, jaundice, or other biliary symptoms promptly.