Nokea
A client is prescribed atenolol. After administering the drug, the nurse would be alert for which of the following? Select all that apply.
- A. Cough
- B. Hyperkalemia
- C. Bradycardia
- D. Dizziness
- E. Constipation
Correct Answer: C,D
Rationale: Common adverse reactions seen with atenolol, a beta-adrenergic blocker, include bradycardia, dizziness, fatigue, weakness, hypotension, nausea, vomiting, diarrhea, and nervousness. Cough is associated with ACE inhibitors. Hyperkalemia is associated with eplerenone and aliskiren. Constipation is not a common adverse reaction with atenolol.
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A client is prescribed an antihypertensive drug. Which of the following would the nurse include in the teaching plan to promote the best outcome for the client? Select all that apply.
- A. Never discontinue use of the antihypertensive drug except on the advice of the physician.
- B. Avoid the use of nonprescription drugs unless approved by the physician.
- C. Avoid alcohol unless its use has been approved by the physician
- D. Know that unexplained weakness or fatigue is a normal adverse reaction.
- E. Notify the physician if the diastolic pressure suddenly increases to 130 \mathrm{~mm} \mathrm{Hg} or higher.
Correct Answer: A,B,C,E
Rationale: The client should be told to never discontinue the drug unless advised to do so, avoid nonprescription drugs unless approved, avoid alcohol unless it's approved, and notify the physician if the diastolic pressure suddenly increases to 130 \mathrm{~mm} \mathrm{Hg} or higher. The client also should contact the physician if unexplained weakness or fatigue occurs.
A nurse is caring for a client experiencing a hypertensive emergency. The nurse understands that if blood pressure is not lowered immediately damage to which of the following can occur? Select all that apply.
- A. Heart
- B. Kidneys
- C. Gallbladder
- D. Pancreas
- E. Eyes
Correct Answer: A,B,E
Rationale: A hypertensive emergency, if not recognized and treated quickly, can result in damage to target organs including the head, kidneys, and eyes.
Angioedema is a potentially life-threatening medical condition that is associated with some classes of antihypertensive medications. The nurse suspects that a client is experiencing angioedema based on which assessment finding? Select all that apply.
- A. Heart rate above 100 beats per minute
- B. Fever greater than 100°C
- C. Swelling of the face
- D. Swelling of the throat
- E. Blood pressure above 170/100 mm Hg
Correct Answer: C,D
Rationale: Angioedema presents with swelling of the face, lips, throat, or extremities.
When developing a presentation for a local community group on hypertension, the nurse integrates information about the importance of blood pressure control. Which of the following would the nurse include? Select all that apply.
- A. Hypertension increases the buildup of atherosclerotic plaque.
- B. Hypertension increases risk of stroke.
- C. Hypertension increases risk of colorectal carcinoma.
- D. Hypertension increases risk of liver disease.
- E. Hypertension increases the workload of the heart.
Correct Answer: A,B,E
Rationale: Hypertension is serious, because it causes the heart to work too hard and contributes to atherosclerosis. It also increases the risk of heart disease, heart failure (HF), kidney disease, blindness, and stroke. Hypertension is not associated with colorectal carcinoma or liver disease.
A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which of the following would be appropriate for the nurse to include in the client's plan of care?
- A. Encouraging ambulation as tolerated
- B. Maintaining bed rest as much as possible
- C. Mandating the use of assistive devices
- D. Encouraging activities early in the morning when fatigue is less
- E. Promoting rest periods throughout the day as necessary
Correct Answer: A,E
Rationale: The client is encouraged to walk and ambulate as he or she can tolerate. Assistive devices may be used if needed, but these should not be mandated for use. The client can gradually increase tolerance by increasing the daily amount of activity. Planning rest periods according to the individual's tolerance is appropriate. Rest can take many forms, such as sitting in a chair, napping, watching television, or sitting with legs elevated.