Module 4 Quiz

A client received epinephrine for an anaphylactic reaction in the emergency department 6 hours ago. Since that time, the client has been unable to void. What assessment should the nurse perform to determine the cause of urinary issue?

Palpate the area above the symphasis pubis bone [Epinephrine is an adrenergic agonists and can cause both urinary retention and impaired renal tissue perfusion. The nurse should assess for urinary retention by either palpating the bladder, just above the symphasis pubis bone, or performing a bladder scan.]

A young female client of child-bearing age with hypertension is started on losartan. What information about family planning should the nurse include in the teaching plan?

"Losartan can cause birth defects in the developing fetus and should be stopped prior to becoming pregnant if possible." [ACE inhibitors and ARB's both cause birth defects in the fetus and should be discontinued prior to becoming pregnant if possible. Betablockers the the common antihypertensive medication used when needed during pregnancy, however, they can cause decreased intrauterine fetal growth.]

When providing education about antihypertensive medications. in general, what information should the nurse provide to the patient? SELECT ALL THAT APPLY

"Rise slowly,from sitting to standing." "Check your blood pressure and pulse prior to taking medication each morning." "Do not stop the medication abruptly." [With each classification of antihypertensive medications, it is important to teach: Do not stop abruptly or rebound hypertension can occur (betablocker can also have myocardial infarction)]

What information should the nurse include when providing education to a patient newly prescribed furosemide? SELECT ALL THAT APPLY

"When standing up,rise slowly,in stages. "Weigh yourself every day,in the same clothes and on the same scale." "Increase dietary intake of potassium rich foods."

The nurse is administering 80 mg of furosemide by intravenous push per the health care providers orders. The nurse will administer the furosemide over [blank1] minutes based on the recommended rate of administration. (Enter a number only in the blank)

4 [Furosemide should be administered at a rate not to exceed 20 mg/minutes.]

What are the adverse effects associated with amlodipine? SELECT ALL THAT APPLY

Ankle edema Flushing Hypotension Bradycardia Reflex tachycardia

The nurse administered epinephrine to a client with a severe case of angioedema related to administration of ACE inhibitors. What adverse effects should the nurse monitor for in this client? SELECT ALL THAT APPLY

Agitation Tremors Palpitations Urinary retention Impaired renal tissue perfusion [Epinephrine is an adrenergic agonist and causes stimulation of the sympathetic nervous system response. The adverse effects are related to stimulation..]

A client with hypertension and benign prostatic hyperplasia is prescribed tamsulosin. What data demonstrates the medication has achieved the therapeutic response?

Client is able to fully empty bladder. [Tamsulosin is an alpha-1 blocker that is used to relax the prostate and neck of the bladder to help client's with BPH empty their bladder. It helps decrease frequency, urgency, and nocturia. It can cause orthostatic hypotension as an adverse effect.]

The nurse is about to administer a prescribed dose of metoprolol to a client with a cardiac dysrhythmia. What assessment data would be of most concern to the nurse?

Heart rate at 50 beats per minutes. [Metoprolol is a cardio-selective beta blocker, meaning it mostly effects beta 1 with very little crossover to beta 2. If a client's heart rate is less than 60, the dose should be held and the health care provider notified.]

Prior to assuming care on a client, you review the client's medical records found below. Admitting diagnosis: Hypertensive crisis, tachycardia Past medical history: Hypertension, atrial fibrilation Past surgical history: None Admitting Medication orders: Lisinopril 20 mg PO daily Aspirin 81 mg PO daily Spironolactone 50 mg PO every morning Metoprolol 25 mg PO BID Hydralazine 20 mg IV push Q 1-hour PRN SBP greater than 150 or DBP greater than 100. Lab data and Vital Signs: Vital signs: Temperature 98.5 Blood pressure 210/120 Pulse 130 Respiratory Rate 18 Chemistry Panel: Sodium 141 mEq/ L Potassium 5.5 mEq/ L Chloride 104 mEq/ L Bicarbonate 20 mEq BUN 55 mg/ dL Creatinine 2.5 mg/dL Calcium 8.7 mEq/L Glucose 105 mg/dL Based on the data listed above, what medication orders should the nurse question? SELECT ALL THAT APPLY

Lisinopril Spironolactone [Since the patient has high potassium and renal impairment, as evidenced by the elevated BUN and creatinine level, both lisinopril and spironolactone used concurrently could place the client at greater risk for hyperkalemia and renal impairment.]