Pharmacology Made Easy 4.0 The Cardiovascular System

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (Select all that apply.)

"Apply the patch to a hairless area and rotate sites" is correct. Hair can interfere with the adhesion of the patch. Rotating patch application sites helps prevent skin irritation."Apply a new patch when you start your day" is correct. The therapeutic preventive effects of transdermal nitroglycerin patches begin 30 to 60 min after application and last for up to 14 hr. Because angina pain is more likely to occur with activity, most clients require this protection during waking hours."Remove patches for 10 to 12 hr each day" is correct. Removing the patches for 10 to 12 hr each day helps prevent the development of tolerance to the drug. For most clients, sleeping hours are the best time to remove the patch and go "patch-free," because angina pain is more likely during activity.

A nurse is teaching a client who has a new prescription for quinidine. Which of the following statements should the nurse include?

"Monitor your pulse rate and report changes."

A nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions?

Acute myocardial infarction Milrinone, a phosphodiesterase inhibitor, is contraindicated for clients who have had an allergic reaction to phosphodiesterase inhibitors and for clients who have an acute myocardial infarction and aortic or pulmonary valve disorders

A nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication?

Antigen-binding fragments

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported?

Facial edema Losartan, an angiotensin II receptor blocker, can cause angioedema, which often manifests as swelling around the eyes and lips. Clients who develop this adverse effect should stop taking the drug and seek medical attention.

A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug?

Grapefruit juice

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of this drug?

Headache Adverse effects of nitrates, such as nitroglycerin, include headaches, which can be severe at the beginning of nitrate therapy but decrease in severity with continued exposure to nitrates.

A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug?

Hyperuricemia

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions?

Hypotension Large amounts of grapefruit juice can increase blood levels of verapamil by inhibiting its metabolism. An excess amount of the drug in the body can intensify otherwise therapeutic effects like hypotension, causing serious risk for syncope and dizziness.

A nurse is caring for a client who has a new prescription for dobutamine. The nurse should clarify the prescription with the provider if the client is receiving which of the following types of drugs? (Select all that apply.)

MAOI is correct. MAOIs can cause toxicity when clients take them while also taking dobutamine. This significantly increases the client's risk for tachydysrhythmias. General anesthetic is correct. General anesthetics can cause dysrhythmias when clients take them while also taking dobutamine.Tricyclic antidepressant is correct. Tricyclic antidepressants can cause toxicity when clients take them while also taking dobutamine. This significantly increases the client's risk for tachydysrhythmias.Beta blocker is correct. Beta blockers, such as propranolol, can decrease the effects of dobutamine.

A nurse is providing teaching to a client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy?

Muscle pain

A nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects?

Myopathy

A nurse is caring for a client who has a new prescription for propranolol to treat a tachydysrhythmia. The nurse should instruct the client to avoid taking which of the following types of over-the-counter drugs while taking propranolol?

NSAIDs NSAIDs can interact with propranolol and decrease the anti-hypertensive action because vasoconstriction can occur in some COX-2 inhibitors. The nurse should instruct the client to avoid taking NSAIDs and propranolol at the same time.

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions?

Second-degree AV block

A nurse is caring for a client who is taking carvedilol and has a prescription for an oral antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for which of the following conditions?

Hypoglycemia

A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug?

The drug does not promote diuresis for clients who have renal insufficiency.

A nurse is reviewing new prescriptions with a client who has heart disease. The nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia?

Simvastatin Simvastatin is an HMG-CoA reductase inhibitor. It blocks synthesis of cholesterol by the body to help lower cholesterol levels.

A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? (Select all that apply.)

Hyperkalemia is correct. Aliskiren, a direct renin inhibitor, can cause elevated potassium levels, especially when taken in combination with an ACE inhibitor, potassium supplements, or potassium-sparing diuretics. The nurse should obtain a potassium level at baseline and periodically monitor the client's potassium level thereafter.Throat swelling is correct. Aliskiren can cause angioedema, which is swelling of the mouth and throat. Clients who develop this adverse effect should stop taking the drug and seek medical attention. Cough is correct. Aliskiren, a direct renin inhibitor, can cause a cough.

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects?

Hypokalemia

A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values requires immediate intervention?

Potassium 5.2 mEq/L

A nurse should identify that which of the following drugs is used only for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long-term use?

Procainamide

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake?

Raisins Diuretics can deplete the body of potassium, so the nurse should instruct the client to include potassium-rich foods in their diet, such as raisins and other dried fruits.

A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include? (Select all that apply.)

Report any new intolerance to fried foods is correct. Because gemfibrozil, a fibrate, can cause gallstones, clients should monitor and report any new intolerance to fried foods, as well as any bloating or upper abdominal discomfort.Report muscle tenderness is correct. Because gemfibrozil, a fibrate, can cause myopathy, clients should monitor and report any unexplained muscle or joint pain.Expect periodic liver function testing is correct. Because gemfibrozil, a fibrate, increases the risk for liver toxicity, clients will require liver function testing while taking this drug.

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? (Select all that apply.)

Rash is correct. Captopril, an ACE inhibitor, can cause a persistent rash. This often indicates the need to discontinue drug therapy. Distorted taste is correct. Captopril can cause distortions in taste sensations and loss of taste, which can lead to anorexia and weight loss. This often indicates the need to discontinue drug therapy. Swelling of the tongue is correct. Captopril can cause angioedema, often manifesting as edema of the tongue, pharynx, and glottis. Clients who develop this adverse effect should discontinue the drug and seek medical attention. Dry cough is correct. Captopril can cause a dry cough because of an accumulation of bradykinin. This often indicates the need to discontinue drug therapy.

A nurse is caring for a client who has a depressive disorder and requires a prescription drug to treat hypertension. The nurse should recognize that which of the following antihypertensive drugs is contraindicated for this client?

Reserpine