Calcium Channel Blockers

A patient who is taking diltiazem asks the nurse, "Why do I need to weigh myself daily?" How should the nurse respond? "Diltiazem can worsen heart failure, and weight gain is an indicator of worsening heart failure." "Increased appetite is a common adverse drug effect associated with diltiazem use." "Diltiazem can worsen heart failure, and weight loss is an indicator of worsening heart failure." "Weight loss is a sign of anorexia, which is an adverse drug effect associated with diltiazem use."

"Diltiazem can worsen heart failure, and weight gain is an indicator of worsening heart failure."

The nurse is providing discharge teaching for a patient taking a calcium channel blocker. What should the nurse include in patient teaching to decrease the risk of lightheadedness? "Remain in a supine position for 1 hour after taking your medication." "Do not engage in physical activity for 2 hours after taking your medication." "Split the dose of the calcium channel blocker over 4 hours." "Rise slowly from a sitting or lying position."

"Rise slowly from a sitting or lying position."

Verapamil is used to treat which conditions? Select all that apply. Edema Angina Acute hypertension Cardiac dysrhythmias Long-term high blood pressure

Angina Cardiac dysrhythmias Long-term high blood pressure

A provider has ordered long-acting diltiazem for a patient with angina pectoris. In order to monitor the effectiveness of diltiazem the nurse should complete which assessments? Baseline vital signs Baseline electrocardiogram Baseline pulmonary function tests Baseline data on frequency and severity of angina attacks

Baseline data on frequency and severity of angina attacks

How does verapamil reduce the amount of oxygen required by the myocardium in a patient with angina pectoris? By venodilation By increasing coronary blood flow and decreasing after load By increasing myocardial contractility By slowing electrical conduction through the atrioventricular node

By increasing coronary blood flow and decreasing after load

How do calcium channel blockers affect vascular smooth muscle? Calcium channel blockers constrict vascular smooth muscle. Calcium channel blockers dilate vascular smooth muscle. Calcium channel blockers enhance vascular smooth muscle proliferation. Calcium channels blockers dilate the vascular smooth muscle of veins.

Calcium channel blockers enhance vascular smooth muscle proliferation.

What should the nurse assess in a patient who is taking verapamil and digoxin to determine if the patient is experiencing a drug interaction? Decreased heart rate Increased heart rate Increased blood pressure Decreased blood pressure

Decreased heart rate

Nifedipine and amlodipine belong to which group of calcium channel blockers? Alpha blockers Dihydropyridines Nondihydropyridines Adrenergic blockers

Dihydropyridines

What are the priority teaching measures for the patient on verapamil? Select all that apply. Keep a three-month supply of verapamil on hand at all times. Do not drink grapefruit juice while you are on verapamil. Monitor blood pressure and heart rate regularly. Swallow the extended-release verapamil tablets and capsules whole. If you miss a dose of verapamil, take the missed dose with your next dose. Seek immediate medical attention for confusion, profound dizziness, severe hypotension, and/or slowed heart rate.

Do not drink grapefruit juice while you are on verapamil. Monitor blood pressure and heart rate regularly. Swallow the extended-release verapamil tablets and capsules whole. Seek immediate medical attention for confusion, profound dizziness, severe hypotension, and/or slowed heart rate.

What adverse reactions of amlodipine could Ms. Jones experience? Select all that apply. Flushing Headache Constipation Heart failure Peripheral edema Reflex tachycardia

Flushing Headache Peripheral edema Reflex tachycardia

Why must patients being treated with calcium channel blockers avoid consuming grapefruit juice? Grapefruit juice can increase levels of select calcium channel blockers. Grapefruit juice can decrease levels of select calcium channel blockers. Grapefruit juice decreases the effectiveness of the calcium channel blockers. Grapefruit juice has similar adverse effects as calcium channel blockers.

Grapefruit juice can increase levels of select calcium channel blockers.

The nurse is providing patient teaching for a patient taking diltiazem. Which adverse effect does the nurse teach the patient may occur when a diuretic is also prescribed? Hypotension Flushing Hypokalemia Peripheral edema

Hypotension

What side effect is more likely to occur with nifedipine? Headache Tachycardia Hypotension Dizziness

Hypotension

A patient diagnosed with hypertension is placed on amlodipine. Why did the patient's health care provider order amlodipine as a daily dose? To enhance patient compliance. As a cost-saving measure for the patient. It has a long half-life. So the peak effect of the drug would occur in 18 hours.

It has a long half-life

The nurse should use caution when administering calcium channel blockers to patients with which condition? Hypertension Mild heart failure Sick sinus syndrome Atrial dysrhythmia

Mild heart failure

Which finding requires further teaching? Ms. Jones reports eating grapefruit for breakfast each morning on her new diet. Ms. Jones states she swallows her capsules whole with a full glass of water each morning. The patient reports she regularly checks her blood pressure at the pharmacy. The patient reports she has decreased the intake of fat in her diet.

Ms. Jones reports eating grapefruit for breakfast each morning on her new diet.

A 52-year-old patient presents to the Emergency Department with a blood pressure of 230/118 mm Hg. The nurse anticipates which orders for a calcium channel blocker? Nifedipine Diltiazem Verapamil Amlodipine

Nifedipine

What information should be included in discharge teaching for a patient on amlodipine? Select all that apply. Amlodipine must be taken with meals. Notify the health care provider if your ankles swell. Amlodipine should be taken twice a day. Avoid drinking alcohol while taking amlodipine. You need a follow-up appointment with your provider in three months. Slowly rise from a sitting or lying position.

Notify the health care provider if your ankles swell. Avoid drinking alcohol while taking amlodipine. Slowly rise from a sitting or lying position.

Which may result from abrupt withdrawal of a calcium channel blocker? Select all that apply. Rebound hypertension Worsening heart failure Hypotension Headache Worsening tissue ischemia

Rebound hypertension Worsening tissue ischemia

Nifedipine and a beta blocker are ordered for a patient with newly diagnosed hypertension. The beta blocker was ordered to prevent which adverse effects commonly associated with nifedipine? Hypotension Reflex bradycardia Reflex tachycardia Decreased contractility

Reflex tachycardia

Which interventions may decrease the adverse effects associated with calcium channel blocker therapy? Select all that apply. Restricting dietary fluids Rising slowly from a sitting or lying position Consuming adequate amounts of dietary fluid and fiber Consulting the health care provider prior to taking over-the-counter medications, vitamins, or herbal remedies Monitoring weight gain

Rising slowly from a sitting or lying position Consuming adequate amounts of dietary fluid and fiber Consulting the health care provider prior to taking over-the-counter medications, vitamins, or herbal remedies

What adjustments in drug dosing need to be made when a patient is treated with both verapamil and digoxin? The dose of digoxin should be increased. The digoxin must be discontinued. The verapamil should be administered at one-half the standard starting dose. The dose of digoxin should be decreased.

The dose of digoxin should be decreased.

A patient with peripheral edema, secondary to malnutrition, has been ordered a calcium channel blocker for the treatment of hypertension. Why would a nurse question this order? The pre-existing peripheral edema may worsen with the use of calcium channel blockers. Calcium channel blockers decrease serum albumin levels. Calcium channel blockers do not effectively treat hypertension. A patient who is malnourished will not be able to effectively metabolize calcium channel blockers.

The pre-existing peripheral edema may worsen with the use of calcium channel blockers.

How do calcium channel blockers affect the myocardium? They have a negative inotropic effect on the myocardium. They have a positive inotropic effect on the myocardium. They enhance the contractility of the myocardium. They strengthen the myocardium.

They have a negative inotropic effect on the myocardium.