Chapter 43, 46 & 51 PrepU
A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement?
"I will take a pill every 15 minutes until the pain subsides."
When describing the action of chlorothiazide, what would a nurse include?
Blocking of the chloride pump
The 47 year old client is experiencing chest pain and has taken three sublingual nitroglycerin tablets, but the pain remains. What should the client do next?
Call 911
A client is receiving fosinopril. Which adverse effect would the nurse caution the client about to help promote compliance?
Cough Explanation: Fosinopril is associated with an unrelenting cough that can lead clients to discontinue the drug. Constipation is an adverse effect of ACE inhibitors, but would not necessarily lead a client to discontinue the drug. GI irritation is an adverse effect of ACE inhibitors, but would not necessarily lead a client to discontinue the drug. Photosensitivity is an adverse effect of ACE inhibitors, but would not necessarily lead a client to discontinue the drug.
A patient has been prescribed a beta adrenergic blocker to help control angina. What effect might the patient experience as a result of the drug therapy?
Decreased cardiac output Explanation: Beta-adrenergic blockers reduce heart rate, cardiac output, and blood pressure. This reduces the heart's oxygen demand, which in turn decreases angina.
The chest pain and pressure a client experiences during an anginal attack is caused by which of the following?
Decreased oxygen supply to the heart
An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabete neuropathy. The nurse has questioned a health care provider's prescription for oral spironolactone because the clients health problems would contribute to a high risk of which adverse reaction?
Dose dependent QT prolongation
A nurse is preparing to administer spironolactone to a client. The nurse would question this order if which disorder is noted in the client's history?
Hyperkalemia
A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?
Hyperkalemia The major adverse effect of potassium-sparing diuretics such as spironolactone is hyperkalemia. Clients receiving these drugs should not be given potassium supplements and should not be encouraged to eat foods high in potassium.
The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expected to be ordered?
Mannitol
A client is experiencing orthostatic hypotension that is affecting his ability to function. Which medication would be most appropriate?
Midodrine
How can the home care nurse assist the client or the client's family members who have hypertension? (Select all that apply.)
Monitoring for drug effects Promoting compliance with the prescribed pharmacologic modifications Promoting compliance with the prescribed lifestyle modifications
A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond?
Restore and maintain adequate tissue perfusion.
During a routine check up of a 45 year old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment?
Secondary hypertension
A nurse is caring for a 59 year old client who has been prescribed nitroglycerin to control angina. Which adverse effect might the nurse observe in this client?
hypotension
A primary health care provider has prescribed a loop diuretic for hypertension in a client with diabetes mellitus. Which assessment should the nurse prioritize?
increased blood glucose levels
