Clonidine

A client is receiving clonidine (catapres) 0.1mg/24hr via transdermal patch. Which assessment finding indicates that the desired effect of the medication has been achieved? A. client denies recent episodes of angina B. Change in peripheral edema from +3 to +1 C. Client denies recent nausea or vomiting D. Blood pressure has changed from 180/120 to 140/70

D. Blood pressure has changed from 180/120 to 140/70 Catapres acts as a centrally-acting analgesic and antihypertensive agent. D. indicates a reduction in hypertention

A patient complains to the nurse that the clonidine (Catapres) recently prescribed for hypertension is causing drowsiness. Which response by the nurse to this concern is appropriate? a. "Drowsiness is a common side effect initially, but it will lessen with time." b. "You may also experience orthostatic hypotension along with the drowsiness." c. "You may be at risk for addiction if you have central nervous system side effects." d. "You should discontinue the medication and contact your prescriber."

a. "Drowsiness is a common side effect initially, but it will lessen with time." CNS depression, evidenced in this patient by drowsiness, is common in about 35% of the population. These responses become less intense with continued drug use. Orthostatic hypotension is less likely with clonidine, because its antihypertensive effects are not posture dependent. The experience of drowsiness does not indicate abuse potential. The patient should not discontinue the medication abruptly because of the potential for rebound hypertension; the patient should contact the prescriber before stopping the medication.

A prescriber has ordered clonidine (Catapres) for a patient who has hypertension. The nurse teaches the patient about side effects of this drug. Which statement by the patient indicates understanding of the teaching? a. "I should chew sugar-free gum or drink water to reduce dry mouth." b. "I should not drive as long as I am taking this drug." c. "I should stand up slowly when taking this medication." d. "I should stop taking this drug if I feel anxious or depressed."

a. "I should chew sugar-free gum or drink water to reduce dry mouth." Xerostomia is a common side effect of clonidine and is often uncomfortable enough that patients stop using the drug. Counseling patients to chew sugar-free gum and take frequent sips of liquid can help alleviate this discomfort. Drowsiness is common, but this side effect becomes less intense over time. Patients should be counseled to avoid hazardous activities in the first weeks of therapy if they feel this effect. The hypertensive effects of clonidine are not posture dependent, as they are with the peripheral alpha-adrenergic blockers, so orthostatic hypotension is minimal with this drug. Clonidine causes euphoria, hallucinations, and sedation in high doses and can cause anxiety or depression, although the last two effects are less common. The drug should not be stopped abruptly because of the risk of rebound hypertension, so patients experiencing unpleasant central nervous system (CNS) effects should consult their provider about withdrawing the medication slowly.

A patient with hypertension has a previous history of opioid dependence. Which medication would the nurse question? a. Clonidine (Catapres) b. Guanabenz (Wytensin) c. Methyldopa d. Reserpine (Serpasil)

a. Clonidine (Catapres) Patients who abuse cocaine, opioids, and other such drugs also frequently abuse clonidine, so this agent would not be the best choice for this patient. The other drugs do no share this abuse potential.

A patient who has been taking clonidine (Catapres) for several weeks complains of drowsiness and constipation. What will the nurse do? a. Recommend that the patient take most of the daily dose at bedtime. b. Suggest asking the provider for a transdermal preparation of the drug. c. Suspect that the patient is overusing the medication. d. Tell the patient to stop taking the drug and call the provider.

a. Recommend that the patient take most of the daily dose at bedtime. CNS depression is common with clonidine, but this effect lessens over time. Constipation is also a common side effect. Patients who take most of the daily amount at bedtime can minimize daytime sedation. Transdermal forms of clonidine do not alter adverse effects. Patients who are abusing clonidine often experience euphoria and hallucinations along with sedation, but they generally find these effects desirable and would not complain about them to a healthcare provider. Clonidine should not be withdrawn abruptly, because serious rebound hypertension can occur.

A client who takes clonidine (Catapres) is to be discharged to home. Which instruction will the nurse include when teaching this client? a. "Your blood pressure should be checked by a health care provider at least once a year." b. "Increasing fluid and fiber in your diet can help prevent the side effect of constipation." c. "Intense exercise or prolonged standing is not a problem with clonidine as it can be with other antihypertensive agents." d. "If you are having difficulty with the common side effect of drooling, notify your health care provider so your dosage can be adjusted."

b. "Increasing fluid and fiber in your diet can help prevent the side effect of constipation."

A 62-year-old patient who has just arrived in the emergency department complaining of a sudden-onset severe headache and nausea has a BP of 240/118 mm Hg. The patient gives a history of taking clonidine (Catapres) and hydrochlorothiazide (HydroDIURIL) for 10 years for hypertension. The most appropriate question by the nurse at this time is a. Have you recently taken any antihistamine medications? b. Have you been taking the Catapres and HydroDIURIL lately? c. Do you have any recent stressful events in your life? d. Did you take any acetaminophen (Tylenol) yet today?

b. Have you been taking the Catapres and HydroDIURIL lately? Rationale: Sudden withdrawal of antihypertensive medications can cause rebound hypertension and hypertensive crisis. Although many over-the-counter medications can cause hypertension, antihistamines and acetaminophen do not increase BP. Stressful events will increase BP, but not usually to the level in this patient.

The nurse is caring for a client with hypertension who is prescribed Clonidine transdermal preparation. What is the correct information to teach this client? a. Change the patch daily at the same time. b. Remove the patch before taking a shower or bath. c. Do not take other antihypertensive medications while on this patch. d. Get up slowly from a sitting to a standing position.

d. Get up slowly from a sitting to a standing position

A prescriber orders transdermal clonidine (Catapres TTS) for a patient with hypertension. What will the nurse teach this patient? a. That medication given by transdermal patch has fewer systemic side effects b. That localized skin reactions are uncommon c. To apply the patch to intact skin on the forearm or leg d. To change the patch every week

d. To change the patch every week Transdermal patches are to be changed every 7 days. Medication administered by patch has the same therapeutic effect and adverse effects as that given by other routes, except that localized skin reactions may occur and are common with clonidine patches. The patch should be applied to intact, hairless skin on the upper arm or torso.

Which statement would be most appropriate during discharge teaching for a patient receiving transdermal clonidine (Catapres)?

"The patch should be applied to a nonhairy site, and abrupt withdrawal should be avoided."

A client is taking clonidine (Catapres) for treatment of hypertension. The nurse should teach the client about which of the following common adverse effects of this drug? Select all that apply. 1. Dry mouth. 2. Hyperkalemia. 3. Impotence. 4. Pancreatitis. 5. Sleep disturbance.

1. Dry mouth. 3. Impotence. 5. Sleep disturbance. Clonidine (Catapres) is a central-acting adrenergic antagonist. It reduces sympathetic outflow from the central nervous system. Dry mouth, impotence, and sleep disturbances are possible adverse effects. Hyperkalemia and pancreatitis are not anticipated with use of this drug.

Which statement is the most appropriate to include in the teaching plan for a 30-year-old woman beginning a new prescription of clonidine (Catapres)? A. "If you stop taking this drug abruptly, your blood pressure might go up very high." B. "You will need to have your blood drawn regularly to check for anemia." C. "Take this medication first thing in the morning to reduce nighttime wakefulness." D. "This medication often is used to manage hypertension during pregnancy."

A. "If you stop taking this drug abruptly, your blood pressure might go up very high."

The nurse is preparing to administer a dose of clonidine (Catapres). Which is the best description of the action of this drug? A. It selectively activates alpha2 receptors in the central nervous system (CNS). B. It causes peripheral activation of alpha1 and alpha2 receptors. C. It depletes sympathetic neurons of norepinephrine. D. It directly blocks alpha and beta receptors in the periphery.

A. It selectively activates alpha2 receptors in the central nervous system (CNS).

The nurse is assessing a patient in a clinic who has been taking clonidine (Catapres) for hypertension. Which findings are most indicative of an adverse effect of this drug? A. Cough and wheezing B. Epigastric pain and diarrhea C. Drowsiness and dry mouth D. Positive Coombs' test result and anemia

C. Drowsiness and dry mouth