Chapter 16 - book Qs, Evolve Flashcards
- When a patient is prescribed an antihypertensive drug for blood pressure changes that occurred after chronic kidney disease, what is the alteration in blood pressure called?
A. Diastolic blood pressure B. Systolic blood pressure C. Primary hypertension D. Secondary hypertension
D
- When a patient is prescribed an antihypertensive drug for blood pressure changes that occurred after chronic kidney disease, what is the alteration in blood pressure called?
A. Diastolic blood pressure B. Systolic blood pressure C. Primary hypertension D. Secondary hypertension
A C D F
- Which action must you take before giving any antihypertensive drug?
A. Weigh the patient. B. Get a list of all drugs the patient is taking. C. Determine whether the patient has an infection. D. Perform a complete physical assessment.
B
- A patient with chronic uncontrolled hypertension is prescribed several antihypertensive drugs. The prescriber orders prazosin (Minipress). When should you administer the first dose?
A. 9 AM after breakfast B. 12 noon with lunch C. 5 PM with dinner D. 10 PM at bedtime
D
- An older adult patient with hypertension, chronic kidney disease, and liver failure is prescribed an ARB drug. What special precaution do you expect for this patient? A. The patient should be given this drug with food. B. The patient should be given a lower dose of this drug. C. The patient should be instructed to report diarrhea to the prescriber. D. The patient should be given this drug twice a day on an empty stomach.
B
- A patient who is taking an ACE inhibitor for hypertension asks how this drug lowers blood pressure. What is your best response?
A. “It eliminates excess water and salt from the body.” B. “It blocks the conversion of angiotensin II.” C. “It reduces the heart rate.” D. “It dilates the arteries.”
B
- A patient who is taking captopril (Capoten) 25mg twice daily develops dizziness. What is your priority action?
A. Keep the patient on bed rest. B. Withhold the dose and notify the prescriber. C. Instruct the patient to call for help when getting out of bed. D. Place all four side rails in the upright position.
C
- A patient prescribed hydralazine (Apresoline) develops a severe inflammatory eruption of the skin and mucous membranes. What is your best action?
A. Apply an aloe-based lotion to the area. B. Reassure the patient that this is an expected side effect. C. Document these findings as the only action. D. Hold the drug and notify the prescriber.
D
- Which statement by a patient who is prescribed metoprolol (Lopressor) indicates the need for additional teaching?
A. “I will get out of bed slowly to avoid dizziness and decrease the risk of falling.” B. “I will notify my prescriber if I experience any chest pains. C. “I will wear a sunscreen, long sleeves, and hat when I go outdoors.” D. “I will stop taking this drug if my heart rate is less than 70 beats per minute.”
D
- A woman is prescribed oral methyldopa (Aldomet) to control pregnancy-induced hypertension. What must you teach the patient about this drug?
A. Safe use of this drug during pregnancy has not been researched. B. This drug can be used safely during pregnancy and breastfeeding. C. This drug has fewer side effects than many other antihypertensive drugs. D. Research demonstrates that this drug causes birth defects in laboratory animal studies.
B
- A patient takes enalapril (Vasotec) 5mg once a day to control high blood pressure. For which life-threatening adverse effect do you assess the patient?
A. Myocarditis B. Angioedema C. Liver failure D. Stevens-Johnson syndrome
B
- Which signs/symptoms must you be sure to check for every 4 to 8 hours after giving a drug to treat high blood pressure? (Select all that apply.)
A. Dizziness B. Decreased axillary temperature C. Hand grasp strength D. Crackles in lungs E. Blood pressure F. Heart rate G. Weight
A D E F
- Which points must you be sure to teach the patient who is going home and continuing to take prazosin (Minipres) 2mg twice daily for blood pressure control? (Select all that apply.)
A. Do not drive or operate machines. B. Avoid salt substitutes. C. Remember to change positions slowly. D. Weigh yourself twice a week. E. Take two pills of the drug in the evening if you miss your morning dose. F. Report any ankle swelling to your prescriber. G. Avoid aspirin or aspirin-containing products.
A C D F
- A 33-year-old female patient is currently taking captopril (Capoten) 12.5mg daily to control her high blood pressure. She tells her prescriber that she plans to become pregnant. What drug will the prescriber most likely prescribe now?
A. nadolol (Corgard) B. clonidine (Catapres) C. methyldopa (Aldomet) D. lisinopril (Prinivil, Zestril)
C
The nurse is ordered to give an antihypertensive drug to a patient. The nurse knows that before administering any type of antihypertensive drug to a patient, what must always be checked first? (select all that apply)
Select all that apply.
Blood pressure Heart rate Serum potassium level Complete drug list Creatinine levels
Blood pressure
Heart rate
Complete drug list
The nurse is volunteering at a blood pressure clinic. The nurse knows that what blood pressure reading indicates hypertension? (select all that apply)
Select all that apply.
150/90 mm Hg 150/85 mm Hg 135/90 mm Hg 120/80 mm Hg 90/60 mm Hg
150/90 mm Hg
150/85 mm Hg
135/90 mm Hg
A patient who is taking antihypertensive drugs asks the nurse why over-the-counter (OTC) medications for colds, allergies, or appetite control are not allowed to be taken without checking with their prescriber. What is the nurse’s best response?
“Many of those drugs contain ingredients that can increase your blood pressure.”
“There are so many potential drug interactions it is better to be safe than sorry.”
“Over-the-counter (OTC) drugs are not regulated as well as prescribed medications.”
“Those medications tend to dramatically drop your blood pressure.”
“Many of those drugs contain ingredients that can increase your blood pressure.”
A patient with high blood pressure should not take OTC drugs that contain phenylephrine such as drugs for allergy, cold, appetite control, asthma, and hay fever because these drugs can increase and not decrease blood pressure. Some drugs may contain caffeine and other cardiac stimulants. Before taking any OTC drugs, the patient needs to check with their prescriber first. The nurse needs to obtain a complete list of any OTC drugs that the patient is currently using, including herbal drugs. OTC and herbal medications are not controlled and FDA approved.
The nurse is about to administer an antihypertensive drug to a patient. The nurse knows that what antihypertensive drug class blocks the effects of angiotensin II leading to increased vasodilation of arteries?
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin II receptor antagonists
Beta blockers
Calcium channel blockers
Angiotensin II receptor antagonists
Angiotensin II receptor blockers (antagonists) block the activation of angiotensin II type 1 receptors by increasing vasodilation of arteries. ACE inhibitors block the production of angiotensin II (potent vasoconstrictor) and help blood vessels relax and decrease blood pressure. Beta blockers reduce the heart rate and the force of muscle contraction, resulting in reduction of oxygen demand. Calcium channel blockers relax the blood vessels, increase the supply of oxygen-rich blood to the heart, and reduce the workload of the heart.
A patient is scheduled for a cardiac stress test. The nurse knows that what class of drug the patient is taking may affect the results of this medical test?
Angiotensin-converting enzyme (ACE) inhibitors
Direct vasodilators
Beta blockers
Diuretics
Beta blockers
Beta blockers can affect the results of cardiac stress tests and other medical tests that raise heart rate and blood pressure. Direct vasodilators, ACE inhibitors, and diuretics do not affect the results of a stress test.
A patient took a dose of lisinopril (Zestril), an ACE inhibitor. The patient phones the nurse and reports sudden onset of swelling of the eyes and lips. What should the nurse do next?
Tell the patient to take over-the-counter diphenhydramine (Benadryl).
Tell the patient to call 911 immediately.
Ask the patient how long he or she has been taking the drug.
Tell the patient to see their prescriber right away.
Tell the patient to call 911 immediately.
911 must be called immediately. Angioedema is a diffuse swelling of the eyes, lips, and tongue and signals a life-threatening, emergency situation and a serious adverse effect of ACE inhibitors. It can quickly lead to swelling of the trachea (windpipe/airway) and interfere with breathing. Asking the patient how long he or she has been taking the drug is not immediately relevant, because these symptoms can occur months or even years after therapy is started. Taking Benadryl OTC or waiting to see the prescriber are not appropriate actions because immediate intervention is needed.
A patient reports experiencing skin lesions and achy joints to the nurse. This is of particular concern to the nurse when it is revealed that the patient is taking what kind of antihypertensive drug?
Alpha blockers
Beta blockers
Calcium channel blockers
Diuretics
Calcium channel blockers
Calcium channel blockers can cause a severe skin disorder called Stevens-Johnson syndrome. Stevens-Johnson syndrome (erythema multiforme) is a potentially lethal skin disorder resulting from an allergic reaction to drugs, infections, or illness. It causes damage to blood vessels of the skin. Symptoms include many different types of skin lesions, itching, fever, joint aching, and generally feeling ill. It is important for the nurse to frequently check patients taking calcium channel blockers for skin lesions, itching, fever, and achy joints. Stevens-Johnson syndrome is not associated with alpha blockers, beta blockers, or diuretics.
The nurse is admitting a patient who has been taking transdermal clonidine (Catapres) at home. What comment by the patient requires immediate intervention?
“My mouth is dry.”
“The little patch with the medicine won’t stay on.”
“I am more tired than usual.”
“I have more nasal congestion.”
“The little patch with the medicine won’t stay on.”
When administering a clonidine patch, be aware that it is packaged with two patches. The smaller patch contains the drug, and the larger patch is used to cover the drug patch. If the patch falls off, a new patch should be placed on the patient. Be sure to record the date and time and initial the patch before placing it on the patient. This patient would need immediate instruction in order to receive the best results from the medication. Dry mouth, drowsiness and lethargy, and nasal congestion are normal side effects of central-acting adrenergic agents.
The nurse is admitting a patient with a diagnosis of untreated hypertension. What health problems can result from this condition? (select all that apply)
Select all that apply.
Kidney failure Cancer Syncope Heart attack Stroke
Kidney failure
Heart attack
Stroke
The nurse is about to give an angiotensin-converting enzyme (ACE) inhibitor to a patient. What side effects are specific to (ACE) inhibitors? (select all that apply)
Select all that apply.
Protein in the urine Persistent dry cough Hypotension Increased white blood cell counts Hypokalemia
Protein in the urine
Persistent dry cough
Hypotension
