Cardiac pharm
The nurse provides instructions to a client who has a prescription for ticlopidine. Which statement made by the client indicates a need for further teaching? "I'll take my medicine with meals." "Blood work will be done every 2 weeks for the first 3 months." "I should not stop the medication without talking to my doctor first." "Food will affect the medication, so I need to take the medication on an empty stomach."
"Food will affect the medication, so I need to take the medication on an empty stomach." iclopidine is an antiplatelet agent that is used for the prevention of thrombotic stroke. Ticlopidine is best tolerated when taken with meals. Blood work is monitored closely, particularly in early therapy, because the medication can cause neutropenia. A client should not stop medication without the primary health care provider's permission.
A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates? "Do not remove the patches." "Have a 12-hour 'no-nitrate' time." "Ensure a 24-hour 'no-nitrate' time." "Keep nitrates on 24 hours, then off 24 hours."
"Have a 12-hour 'no-nitrate' time." To help prevent tolerance, clients need a 12-hour "no-nitrate" time, sometimes referred to as a pharmacological vacation from the medication. The remaining options are incorrect.
The nurse has completed giving medication instructions to a client receiving benazepril. Which client statement indicates to the nurse that the client needs further instruction? "I need to change positions slowly." "I will monitor my blood pressure every week." "I will report signs and symptoms of infection immediately." "I can use salt substitutes freely and eat foods high in potassium."
"I can use salt substitutes freely and eat foods high in potassium." The client taking an angiotensin-converting enzyme (ACE) inhibitor is instructed to take the medication exactly as prescribed, to monitor blood pressure weekly, and to continue with other lifestyle changes to control hypertension. The client should change positions slowly to avoid orthostatic hypotension and report fever, mouth sores, or sore throat (neutropenia) to the health care provider. In addition, salt substitutes and high-potassium foods should be avoided because they contain potassium and increase the risk for hyperkalemia.
A client is to be discharged from the hospital on quinidine gluconate to control ventricular ectopy. The nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? "The best time to schedule this medication is with meals." "I need to avoid alcohol, caffeine, and cigarettes while I am on this medication." "I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs." "I need to take this medication regularly, even if the heartbeat feels strong and regular."
"I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs." Quinidine gluconate is an antidysrhythmic medication used to maintain normal sinus rhythm after conversion of atrial fibrillation or atrial flutter. Diarrhea, nausea, vomiting, loss of appetite, and dizziness all are common side effects of quinidine gluconate. If any of these occur, the primary health care provider (PHCP) or the nurse should be notified; however, the medication should never be discontinued abruptly. Rapid decrease in medication levels of antidysrhythmics could precipitate dysrhythmia. The other options indicate correct information.
Minoxidil is prescribed for a client to treat hair loss. The nurse provides instructions to the client regarding the application of the medication. Which statement by the client indicates that teaching is effective? "I will apply the prescribed amount of solution at bedtime." "I will apply the prescribed amount of solution twice a day." "I will apply the prescribed amount of solution 4 times a day." "I will apply the prescribed amount of solution 3 times a day."
"I will apply the prescribed amount of solution twice a day." A 2% minoxidil solution is used for topical treatment of baldness. The usual dosage is 1 mL applied twice a day. Options 1, 3, and 4 are incorrect.
A client with chronic atrial fibrillation is being started on quinidine sulfate as maintenance therapy for dysrhythmia suppression, and the nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? "I will avoid chewing the tablets." "I will take the dose at the same time each day." "I will take the medication with food if my stomach becomes upset." "I will stop taking the prescribed anticoagulant after starting this new medication."
"I will stop taking the prescribed anticoagulant after starting this new medication." Medication-specific teaching points for quinidine sulfate include to take the medication exactly as prescribed, not to chew the tablets, to take with food if stomach upset occurs, to wear a medical identification (e.g., MedicAlert) bracelet or tag, and to have periodic checks of heart rhythm and blood counts. The client should not stop taking a prescribed medication unless specifically told to do so by the primary health care provider.
Atorvastatin has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? "This medication will lower my cholesterol level." "I will need to have blood tests drawn while I am taking this medication." "I won't need to adhere to a low-fat diet as long as I take this medication faithfully." "I need to talk to the primary health care provider before taking any over-the-counter medications."
"I won't need to adhere to a low-fat diet as long as I take this medication faithfully." Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. The client is instructed to follow a recommended diet as an important component of therapy. Liver function tests and cholesterol and triglyceride level determinations will be performed periodically while the client is taking the medication. The client needs to be instructed to consult with the primary health care provider before taking any over-the-counter medications
The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine, and the nurse teaches the client about the medication. Which statement, by the client, indicates the need for further teaching? "Constipation and bloating might be a problem." "I'll continue to watch my diet and reduce my fats." "Walking a mile each day will help the whole process." "I'll continue my nicotinic acid from the health food store."
"I'll continue my nicotinic acid from the health food store." Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin needs to be avoided. Constipation and bloating are the 2 most common adverse effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.
A neurologist prescribed ticlopidine to the client with thrombotic stroke. The nurse provides instructions to the client and spouse regarding the medication. Which statement made by the client indicates that education was effective? "I'll take the medicine with meals." "If I do not feel well, I should skip the medication." "I won't have another stroke if I take this medicine faithfully." "If I have any gastrointestinal side effects, I should call the neurologist."
"I'll take the medicine with meals." Ticlopidine is an antiplatelet agent that is used to assist in preventing a thrombotic stroke. Ticlopidine is best tolerated when taken with meals. The most common side effects are gastrointestinal (GI) disturbances. Taking ticlopidine with meals tends to lessen those effects. It is not necessary to contact the neurologist or prescribing provider if GI upset occurs. The client should not skip medications. The medication is used to prevent strokes but does not guarantee that a stroke will not occur.
A client is prescribed nicotinic acid for hyperlipidemia, and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions? "It is not necessary to avoid the use of alcohol." "The medication should be taken with meals to decrease flushing." "Clay-colored stools are a common side effect and should not be of concern." "Ibuprofen IB taken 30 minutes before the nicotinic acid should decrease the flushing."
"Ibuprofen IB taken 30 minutes before the nicotinic acid should decrease the flushing." Flushing is an adverse effect of this medication. Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30 minutes prior to taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this effect. The medication should be taken with meals to decrease gastrointestinal upset; however, taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be reported to the primary health care provider (PHCP) immediately.
Atenolol has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? "I need to rise slowly from a lying to a sitting position." "If I feel that my heart rate is too low, I should stop the medication." "It will take 1 to 2 weeks before my blood pressure becomes controlled." "I should avoid tasks that require alertness until I know how the medication will affect my body."
"If I feel that my heart rate is too low, I should stop the medication." Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing blood pressure, and decreasing myocardial oxygen demand. The client should not abruptly stop the medication. Abrupt withdrawal may result in sweating, palpitations, headache, and tremulousness, and may precipitate heart failure or myocardial infarction in a client with cardiac disease. Abrupt withdrawal can also cause rebound hypertension. A pulse of 60 or below should be reported to the primary health care provider. The statements made by the client in the remaining options are correct.
Daily administration of dipyridamole has been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates an understanding of the instructions? "This medication will prevent a stroke." "This medication will prevent a heart attack." "This medication will help keep my blood pressure down." "If I take this medicine with my warfarin, it will protect my artificial heart valve."
"If I take this medicine with my warfarin, it will protect my artificial heart valve." Dipyridamole combined with warfarin sodium is prescribed to protect the client's artificial heart valves. Dipyridamole does not prevent strokes, heart attacks, or hypertension.
Atorvastatin has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond? "It increases plasma cholesterol." "It increases plasma triglycerides." "It decreases low-density lipoproteins (LDLs)." "It decreases high-density lipoproteins (HDLs)."
"It decreases low-density lipoproteins (LDLs)." Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. It decreases LDL cholesterol and plasma triglycerides and increases HDL cholesterol (the good cholesterol). The remaining options are not actions of this medication.
A registered nurse (RN) is orienting a new RN on the use of atorvastatin. Which statement by the new RN indicates that the teaching has been effective? "It is used in heart failure." "It helps to control hypertension." "It helps to reduce episodes of angina pectoris." "It is given to clients with hypercholesterolemia."
"It is given to clients with hypercholesterolemia." Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. The statements made in the remaining options are incorrect.
Minoxidil is prescribed for a client to treat hair loss. The client asks the nurse if the hair will continue to grow when the medication is stopped. What is the appropriate nursing response? "The hair will continue to grow." "Newly gained hair is lost in 3 to 4 months." "It depends on how long you have been taking the medication." "I'm not sure-you need to ask your primary health care provider."
"Newly gained hair is lost in 3 to 4 months." Hair regrowth with the use of minoxidil is most likely to occur when baldness has developed recently and has been limited to a small area. Benefits of the medication take several months. On discontinuation of the medication, newly gained hair is lost in 3 to 4 months, and the natural progression of hair loss resumes. Options 1 and 3 are incorrect. Option 3 places the client's question on hold and is inappropriate.
A client is experiencing impotence after taking guanfacine. The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse? "I can understand completely." "You wouldn't really want to have a stroke." "You are concerned about the effects of your medication." "The primary health care provider should change your prescription."
"You are concerned about the effects of your medication." Reflection of the client's own comment lets the client know that the nurse hears the concern without judging. The nurse cannot understand what the client is experiencing. To tell the client "you wouldn't really want to have a stroke" is confrontational and unsupportive. The client's prescription may need to be changed, but from the options provided this is not the most appropriate response.
Levothyroxine is prescribed for a client diagnosed with hypothyroidism. The nurse reviews the client's record and notes that the client is presently taking warfarin. The nurse contacts the primary health care provider (PHCP), anticipating that the PHCP will prescribe which medication? A decreased dosage of warfarin An increased dosage of warfarin A decreased dosage of levothyroxine An increased dosage of levothyroxine
A decreased dosage of warfarin Levothyroxine accelerates the degradation of vitamin K-dependent clotting factors. As a result, the effects of warfarin are enhanced. Therefore, if thyroid hormone replacement therapy is instituted in a client who has been taking warfarin, the dosage of warfarin should be reduced.
A client is taking ticlopidine hydrochloride. The nurse should tell the client to avoid which substance while taking this medication? Vitamin C Vitamin D Acetaminophen Acetylsalicylic acid
Acetylsalicylic acid Ticlopidine hydrochloride is a platelet aggregation inhibitor. It is used to decrease the risk of thrombotic stroke in clients with precursor symptoms. Because it is an antiplatelet agent, other medications that precipitate or aggravate bleeding should be avoided during its use. Therefore, aspirin or any aspirin-containing product should be avoided. The substances in options 1, 2, and 3 are safe to consume.
The nurse notes a persistent, dry cough in an adult client being seen in the ambulatory clinic. When questioned, the client states that the cough began approximately 2 months ago. On further assessment, the nurse learns that the client began taking quinapril shortly before the time that the cough began. How should the nurse interpret the development of the cough? An early indication of heart failure Caused by neutropenia as a result of therapy Caused by a concurrent upper respiratory infection An expected although bothersome side effect of therapy
An expected although bothersome side effect of therapy A frequent side effect of therapy with any angiotensin-converting enzyme (ACE) inhibitor, including quinapril, is a persistent, dry cough. In general, the cough does not resolve during the course of medication therapy, so clients should be advised to notify the primary health care provider if the cough becomes very troublesome. The other options are incorrect.
Atenolol has been prescribed for a hospitalized client. The nurse should check which item before administering this medication? Pedal pulses Apical heart rate Most recent potassium level Most recent electrolyte levels
Apical heart rate Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing blood pressure, and decreasing myocardial oxygen demand. The nurse should check the client's apical heart rate and blood pressure immediately before administering the medication. If the heart rate is 60 beats/min or lower or if the systolic blood pressure is less than 90 mm Hg, the medication is withheld and the primary health care provider is contacted. The remaining options are unrelated to the administration of this medication.
The primary health care provider (PHCP) writes a prescription for atenolol for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data? Temperature is 100.1º F (37.8º C). Apical heart rate is 48 beats/min. Blood pressure is 138/82 mm Hg. Pedal pulses are bounding and strong.
Apical heart rate is 48 beats/min. Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing blood pressure, and decreasing myocardial oxygen demand. Contraindications to the medication include severe bradycardia, cardiac failure, cardiogenic shock, and heart block greater than first degree. The remaining options are not contraindications to this medication.
A client has recently begun medication therapy with propranolol. The long-term care nurse should plan to notify the primary health care provider (PHCP) if which assessment finding is noted? Complaints of insomnia Audible expiratory wheezes Decrease in heart rate from 86 to 78 beats/min Decrease in blood pressure from 162/90 to 136/84 mm Hg
Audible expiratory wheezes Propranolol is a beta blocker. Audible expiratory wheezes could indicate bronchospasm, a serious adverse reaction. Beta blockers that are not cardioselective, such as propranolol, may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Insomnia is a frequent mild side effect and should continue to be monitored. A normal decrease in heart rate and blood pressure is expected.
The nurse is caring for a client with hyperlipidemia who is taking cholestyramine. Which nursing assessment is mostsignificant for this client relative to the medication therapy? Observe for joint pain. Auscultate bowel sounds. Assess deep tendon reflexes. Monitor cardiac rate and rhythm.
Auscultate bowel sounds. Cholestyramine is used to treat hyperlipidemia. The site of action of the medication is the bowel; therefore, option 2 is correct. The remaining options are unrelated assessments.
The nurse has given a client the prescribed dose of intravenous hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameter? Pulse rate Urine output Blood pressure Potassium level
Blood pressure Hydralazine is an antihypertensive medication used in the management of moderate to severe hypertension. It is a vasodilator medication that decreases afterload. The blood pressure needs to be monitored. The remaining options are unrelated to the use of this medication.
A client is scheduled for a dose of ramipril. The nurse should check which measurement before administering the medication? Weight Apical pulse Blood pressure Potassium level
Blood pressure Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, and a serious adverse effect of this medication is profound hypotension. The client's blood pressure should be checked before administration of this medication. The medication does not cause weight gain or loss, bradycardia, or depletion of potassium.
The nurse should report which assessment finding to the primary health care provider (PHCP) before initiating thrombolytic therapy in a client with pulmonary embolism? Adventitious breath sounds Temperature of 99.4° F (37.4° C) orally Blood pressure of 198/110 mm Hg Respiratory rate of 28 breaths per minute
Blood pressure of 198/110 mm Hg Thrombolytic therapy is contraindicated in severe uncontrolled hypertension because of the risk of cerebral hemorrhage. Therefore, the nurse would report the results of the blood pressure to the PHCP before initiating therapy.
A client has developed paroxysmal nocturnal dyspnea. Which medication should the nurse anticipate will be prescribed by the primary health care provider? Bumetanide Amiodarone Propranolol Streptokinase
Bumetanide Bumetanide is a diuretic. The paroxysmal nocturnal dyspnea may be caused by increased venous return when the client is lying in bed, and the client needs diuresis. Amiodarone is an antidysrhythmic, Propranolol is a beta blocker, and streptokinase is a thrombolytic.
The nurse prepares to teach a client with subarachnoid hemorrhage about the effects of nimodipine. The nurse plans to explain which information about the type and action of this medication? Vasodilator that has an affinity for cerebral blood vessels Beta-adrenergic blocker that will decrease blood pressure Diuretic that will decrease blood pressure by decreasing fluid volume Calcium channel blocker that will decrease spasm in cerebral blood vessels
Calcium channel blocker that will decrease spasm in cerebral blood vessels Nimodipine is a calcium channel-blocking agent that has an affinity for cerebral blood vessels. It is used to prevent or control vasospasm in cerebral blood vessels, thereby reducing the chance for rebleeding. It is typically prescribed for 3 weeks' duration.
The primary health care provider (PHCP) writes a prescription for atorvastatin for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data? Renal calculi Chronic heart failure Carcinoid of the liver Coronary artery disease
Carcinoid of the liver Atorvastatin is a (HMG-CoA) reductase inhibitor that is used to treat hypercholesterolemia and hypertriglyceridemia. Contraindications to the medication include active liver disease, unexplained elevated liver function tests, pregnancy, and lactation. The conditions noted in the remaining options are not contraindications to this medication.
Atenolol hydrochloride is prescribed for a hospitalized client. The nurse should perform which action as a priority before administering this medication? Listen to the client's lung sounds. Check the client's blood pressure. Assess the client for muscle weakness. Check the client's most recent electrolyte levels.
Check the client's blood pressure. Atenolol hydrochloride is a beta blocker that is used to treat hypertension. Therefore, the priority nursing action before administration of the medication is to check the client's blood pressure. The nurse also checks the client's apical heart rate. If the systolic blood pressure is lower than 90 mm Hg or the apical pulse is 60 beats/min or slower, the medication is withheld and the primary health care provider is notified. The nurse checks baseline renal and liver function tests. The medication can cause weakness, and the nurse would assist the client if weakness with activities occurs.
Fenofibrate is prescribed for a client with hyperlipidemia. The nurse reviews the client's medical history for the presence of what condition that contraindicates the use of this medication? Angina Mitral valve stenosis Cirrhosis of the liver Coronary artery disease
Cirrhosis of the liver Fenofibrate is a fibric acid derivative that is used to treat hyperlipidemia. Contraindications to the use of fibrates include known medication allergy, severe liver or kidney disease, cirrhosis, and gallbladder disease.
A primary health care provider (PHCP) prescribes quinidine gluconate for a client. The nurse decides to withhold the medication and contact the PHCP if which assessment finding is documented in the client's medical record? Muscle weakness History of asthma Presence of infection Complete atrioventricular (AV) block
Complete atrioventricular (AV) block Quinidine gluconate is an antidysrhythmic medication used to maintain normal sinus rhythm after conversion of atrial fibrillation or atrial flutter. It is contraindicated in complete AV block, intraventricular conduction defects, and abnormal impulses and rhythms caused by escape mechanisms, and with myasthenia gravis. It is used with caution in clients with preexisting muscle weakness, asthma, infection with fever, and hepatic or renal insufficiency.
A client taking verapamil has been given information about side effects of this medication. The nurse determines that the client understands the information if the client states to watch for which most common side effect of this medication? Weight loss Constipation Nasal stuffiness Abdominal cramping
Constipation Verapamil is a calcium channel blocker. The most common complaint with the use of verapamil is constipation. Other frequent side effects are dizziness, facial flushing, headache, and edema of the hands and feet. Weight loss, nasal stuffiness, and abdominal cramping are not associated with the use of this medication.
A client who has begun taking betaxolol demonstrates an effective response to the medication as indicated by which nursing assessment finding? Increase in edema to 3+ Weight gain of 5 lb Decrease in pulse rate from 74 beats/min to 58 beats/min Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg
Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg Betaxolol is a beta-adrenergic blocking agent used to lower blood pressure, relieve angina, or decrease the occurrence of dysrhythmias. Side and adverse effects include bradycardia and signs and symptoms of heart failure, such as increased edema and weight gain.
Gemfibrozil is prescribed for a client. Which laboratory finding should alert the nurse to the need to withhold the medication and contact the primary health care provider? Elevated glucose Elevated triglycerides Elevated liver function tests Elevated blood urea nitrogen (BUN)
Elevated liver function tests Gemfibrozil is used to treat hypercholesterolemia. One adverse effect is hepatotoxicity. The medication does not affect glucose. An elevated triglyceride level is not an indication to hold the medication. An elevated BUN is unrelated to this medication and would not be an indication that the medication should be held.
Atorvastatin has been prescribed for a client, and the client asks the nurse about the side and adverse effects of the medication. What should the nurse tell the client is a frequent side effect of this medication? Tremors Lethargy Headache Tiredness
Headache Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. A frequent side effect is headache. Occasional side effects include myalgia, rash or pruritus (signs of an allergic reaction), flatulence, and dyspepsia. The symptoms in the remaining options are not side and adverse effects of this medication.
A client who is taking chlorothiazide comes to the clinic for periodic evaluation. In monitoring the client's laboratory test results for medication side effects, what is the clinic nurse most likely to note if a side or adverse effect is present? Hypokalemia Hypocalcemia Hypernatremia Hyperphosphatemia
Hypokalemia The client taking a potassium-losing diuretic such as chlorothiazide should be monitored for decreased potassium levels. Other possible fluid and electrolyte imbalances that occur with use of this medication include hypercalcemia, hyponatremia, hypophosphatemia, and hypomagnesemia.
A client admitted to the hospital is taking atenolol. The nurse monitors the client for which sign or symptom of an adverse effect of the medication? Nausea Diaphoresis Hypotension Tachycardia
Hypotension Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing blood pressure, and decreasing myocardial oxygen demand. Adverse effects include profound bradycardia or hypotension. The remaining options are not adverse effects of this medication. Nausea and diaphoresis are side effects of the medication.
The nurse is planning discharge teaching for a client started on acetazolamide for a supratentorial lesion. Which information about the primary action of the medication should be included in the client's education? It will prevent hypertension. It will prevent hyperthermia. It decreases cerebrospinal fluid production. It maintains adequate blood pressure for cerebral perfusion.
It decreases cerebrospinal fluid production. Acetazolamide is a carbonic anhydrase inhibitor and a diuretic. It is used in the client with or at risk for increased intracranial pressure to decrease cerebrospinal fluid production. The remaining options are not actions of this medication.
Atorvastatin has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? Neutrophil count Liver function studies White blood cell (WBC) count Complete blood cell (CBC) count
Liver function studies Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. Because the medication is metabolized in the liver, baseline and periodic liver function tests, as well as cholesterol and triglyceride level determinations, should be done periodically. The tests identified in the remaining options are unrelated to the administration of HMG-CoA reductase inhibitors.
A client with chronic kidney disease (CKD) who is receiving an antihypertensive medication is experiencing frequent hypotensive episodes. The nurse reviews the client's medication record, knowing that which medication would have the greatest tendency to cause hypotension? Methyldopa Epoetin alfa Levothyroxine Calcium carbonate
Methyldopa Methyldopa is metabolized by the kidneys and requires careful dosage adjustment according to the client's renal function to prevent hypotension. Calcium carbonate is used in the treatment of calcium deficiency and does not cause hypotension when administered via the oral route. Parenteral administration of calcium may cause hypotension. Levothyroxine does not cause hypotension. Epoetin alfa is an erythropoietin and is more likely to cause hypertension than hypotension.
The nurse should educate the client receiving pravastatin to immediately report which finding? Fatigue Diarrhea Sore throat Muscle pain
Muscle pain Pravastatin is used to treat hyperlipidemia. Muscle pain could indicate rhabdomyolysis, a serious complication of this medication. It must be reported immediately. The remaining options are not associated concerns with the medication.
The nurse is reviewing the primary health care provider's (PHCP's) prescriptions for a client recently admitted to the hospital and notes that the PHCP has prescribed ticlopidine therapy. Which finding on the client's record would indicate a need to contact the PHCP before initiating the medication prescription? Neutropenia Client history of stroke Client history of hypertension Complaints of gastrointestinal disturbances
Neutropenia Neutropenia, or agranulocytosis, is the most serious adverse effect associated with the use of ticlopidine. A baseline complete blood cell (CBC) count with differential will be performed for the client. Neutropenia occurs most often within the first 3 months of therapy; therefore, a CBC with differential is recommended every 2 weeks during the first 3 months. If a diagnosis of neutropenia is determined, the client will be withdrawn from therapy. This medication is used to prevent a stroke and is not contraindicated in hypertension. Gastrointestinal disturbances can occur as a result of taking the medication, and the client is instructed to take the medication with food to minimize these side effects.
A client with cardiac disease has begun taking propranolol, and the nurse provides information to the client about the medication. The nurse should tell the client to contact the primary health care provider (PHCP) if which symptoms develop? Insomnia and headache Nausea and constipation Night cough and dyspnea Drowsiness and nightmares
Night cough and dyspnea Propranolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, antidysrhythmic, and antimigraine medication. It may precipitate heart failure or myocardial infarction in clients with cardiac disease. Signs of heart failure include dyspnea (particularly on exertion or lying down), night cough, peripheral edema, and distended neck veins. If signs of heart failure occur, the PHCP should be notified. The symptoms noted in the remaining options identify effects of this medication that do not warrant PHCP notification if they occur.
The nurse has been given a medication prescription to administer intravenous (IV) hydralazine. The nurse obtains which priority piece of equipment needed for use during administration of this medication? Pulse oximetry Cardiac monitor Noninvasive blood pressure cuff Non-rebreather oxygen face mask
Noninvasive blood pressure cuff Hydralazine is an antihypertensive medication used for moderate to severe hypertension. Because the blood pressure and pulse should be monitored frequently after administration, a noninvasive blood pressure cuff should be obtained. The other options are not priority items specific to the use of this medication.
A client is scheduled to have alteplase. Which item should the nurse obtain to monitor side/adverse effects of the medication therapy? Flashlight Pulse oximeter Suction equipment Occult blood test strips
Occult blood test strips Alteplase is a thrombolytic medication that dissolves thrombi or emboli. Bleeding is a frequent and potentially severe adverse effect of therapy. The nurse assesses for signs of bleeding in clients receiving this therapy using occult blood test strips to test urine, stool, or nasogastric drainage. A flashlight is used for pupil assessment as part of the neurological examination in the client who is neurologically impaired. Pulse oximeter and suction equipment would be needed if the client had evidence of oxygenation or respiratory problems.
The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? Fluid overload Peripheral vasoconstriction Inability to perform self-care Inability to discriminate hot or cold sensations
Peripheral vasoconstriction The client who is receiving dopamine therapy should be assessed for peripheral vasoconstriction related to the action of the medication. The remaining options are not related directly to this medication therapy.
The nurse is providing medication information to a client who is beginning medication therapy with enalapril. The nurse should tell the client that which is an anticipated, although unpleasant, side effect of this medication? Rapid pulse Persistent dry cough Increased blood pressure Metallic taste in the mouth
Persistent dry cough The principal side and adverse effects of enalapril, an angiotensin-converting enzyme (ACE) inhibitor, are persistent cough, first-dose hypotension, and hyperkalemia. The medication is used to treat hypertension. A persistent dry cough is a harmless side effect, although it can be disturbing. If this side effect occurs and is troublesome, the primary health care provider should be notified so that the medication can be changed to a different one. A rapid pulse and metallic taste in the mouth are not side or adverse effects of this medication.
A client seen in the health care clinic for follow-up care is taking atorvastatin. The nurse should assess the client for which adverse effect of the medication? Earache Hearing loss Photosensitivity Lung congestion
Photosensitivity Atorvastatin is a reductase inhibitor (HMG-CoA reductase inhibitor) that is used to treat hypercholesterolemia and hypertriglyceridemia. Adverse effects include photosensitivity and the potential for developing cataracts. The symptoms in the remaining options are not side and adverse effects of this medication.
A client is due for a dose of bumetanide. The nurse should temporarily withhold the dose and notify the primary health care provider (PHCP) if which laboratory test result is noted? Sodium level of 137 mEq/L (137 mmol/L) Chloride level of 106 mEq/L (106 mmol/L) Potassium level of 2.9 mEq/L (2.9 mmol/L) Magnesium level of 2.1 mEq/L (1.05 mmol/L)
Potassium level of 2.9 mEq/L (2.9 mmol/L) Bumetanide is a loop diuretic that is not potassium retaining. The value given for potassium is below the therapeutic range of 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L) for this electrolyte. The nurse should notify the PHCP before giving the dose so that potassium supplementation may be prescribed. The results listed in the remaining options identify normal values.
A client is scheduled to take ticlopidine. The nurse plans to take which action before implementing this medication therapy? Take the client's blood pressure. Obtain a prothrombin time (PT). Take the client's apical heart rate. Review the results of the complete blood cell (CBC) count.
Review the results of the complete blood cell (CBC) count. Ticlopidine is an antiplatelet agent that is used for the prevention of thrombotic stroke. Ticlopidine's effects last for the life of the platelet, 7 to 10 days. Ticlopidine also can cause neutropenia, which is an abnormally small number of mature white blood cells (WBCs). Baseline data from a CBC count are necessary before implementation of therapy, and the nurse should monitor for neutropenia during this medication therapy. If this adverse effect does occur, the primary health care provider is notified and therapy should be stopped. The effects of neutropenia are reversible within 1 to 3 weeks. Options 1, 2, and 3 are actions that are not specific to this medication therapy.
Atenolol has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication? Slows the heart rate Increases cardiac output Increases myocardial oxygen demand Maintains the blood pressure at a level within the 140/90 mm Hg range
Slows the heart rate Atenolol is a beta-adrenergic blocker that is used as an antihypertensive, antianginal, and antidysrhythmic. It blocks beta-adrenergic receptors in cardiac tissue and produces the therapeutic effects of slowing the heart rate, decreasing cardiac output, decreasing myocardial oxygen demand, and decreasing blood pressure.
What should the nurse teach a client about an expected outcome of nesiritide administration? The client will have an increase in urine output. The client will have an absence of dysrhythmias. The client will have an increase in blood pressure. The client will have an increase in pulmonary capillary wedge pressure.
The client will have an increase in urine output. Nesiritide is a recombinant version of human B-type natriuretic peptide, which vasodilates arteries and veins. It is used for the treatment of decompensated heart failure, increases renal glomerular filtration, and increases urine output. The remaining options are incorrect about the intended effect of this medication.
The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication? The development of complaints of insomnia The development of audible expiratory wheezes A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after 2 doses of the medication A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after 2 doses of the medication
The development of audible expiratory wheezes Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. Beta blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in blood pressure and heart rate are expected. Insomnia is a frequent mild side effect and should be monitored.
The nurse has completed client teaching on use of thrombolytic medications in acute ischemic stroke. The nurse determines that the educational session was effective if the client states that thrombolytics are used for what purpose? To dissolve clots To prevent ischemia To prevent bleeding To decrease anxiety
To dissolve clots Thrombolytic medications are used to treat acute thrombolytic disorders. These medications dissolve clots. Because these medications alter the hemostatic capability of the client, any bleeding that does occur can be difficult to control. Options 2, 3, and 4 are not actions of this medication.
The nurse is providing instructions to a client with chronic atrial fibrillation who is being started on quinidine sulfate. The nurse should plan to provide which instruction to the client? Wear a MedicAlert bracelet. Take the medication only on an empty stomach. Stop taking the prescribed digoxin when this medication is started. Open the sustained-release capsules and mix with applesauce if the medication is difficult to swallow.
Wear a MedicAlert bracelet. The client should be instructed to wear a MedicAlert bracelet or tag and continue taking digoxin as prescribed. The client should be instructed to take quinidine sulfate exactly as prescribed. The client should not chew the sustained-release capsules or open the capsules and mix them with food. Quinidine sulfate is administered for atrial flutter or fibrillation only after the client has been digitalized.
