Nokea
A nurse is instructing a client about his prescribed antihypertensive therapy with captopril. Which of the following instructions would the nurse include in the teaching plan? Select all that apply.
- A. Taking the drug with meals to decrease GI upset
- B. Informing the client about the possibility of a cough
- C. Crushing the capsule before taking it
- D. Taking measures to reduce injury from hypotension
- E. Reporting any swelling of the face, throat, or extremities
Correct Answer: B,D
Rationale: The client needs to know that some clients experience a dry cough that does not subside until drug therapy is discontinued and this reaction may need to be tolerated. In addition, these drugs may cause a significant drop in blood pressure after the first dose, so the client needs to take measures to reduce the risk of injury from the drug's effects. The ACE inhibitors, captopril and moexipril, should be taken 1 hour before or 2 hours after meals to enhance absorption. The drugs are sustained-release capsules that should not be crushed, opened, or chewed. ACEIs do not cause angioedema.
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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 with hypertension is to receive a calcium channel blocker. The nurse understands that this class of drug leads to which of the following? Select all that apply.
- A. Relaxation of blood vessels
- B. Increased oxygen supply to the heart
- C. Reduced workload on the heart
- D. Decreased blood pressure
- E. Increased workload on the kidneys
Correct Answer: A,B,C,D
Rationale: The use of calcium channel blockers results in relaxation of blood vessels, increased oxygen supply to the heart, reduced workload on the heart, and decreased blood pressure.
After teaching a group of nursing students about hypertension, the instructor determines that the teaching was successful when the students identify which of the following as a risk factor for development of hypertension? Select all that apply.
- A. Advancing age
- B. Family history
- C. Caucasian race
- D. Cigarette smoking
- E. Chronic alcohol consumption
Correct Answer: A,B,D,E
Rationale: Risk factors for hypertension include advancing age, family history, cigarette smoking, and chronic alcohol consumption. African American race is also a risk factor.
After teaching a group of nursing students about antihypertensive drugs, the instructor determines a need for additional teaching when the students identify which of the following as an angiotensin-converting enzyme inhibitor?
- A. Pindolol
- B. Benazepril
- C. Quinapril
- D. Enalapril
Correct Answer: A
Rationale: Pindolol is a beta-adrenergic blocker. Benazepril, quinapril, and enalapril are ACEIs.
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.