Nokea
A nurse reviews a clients medication history for drugs that might interact with the client's prescribed nitrate therapy. Which of the following if administered with nitrates would the nurse identify as causing severe hypotension and possible cardiovascular collapse? Select all that apply.
- A. Alcohol
- B. Beta-2 agonists
- C. HMG-CoA reductase inhibitors
- D. Angiotensin-converting enzyme inhibitors
- E. Phosphodiesterase inhibitors
Correct Answer: A,E
Rationale: Alcohol and phosphodiesterase inhibitors when administered with nitrates can cause severe hypotension and possible cardiovascular collapse.
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A client is receiving treatment for angina with a vasodilator. The nurse instructs the client to notify his primary health care provider about which of the following?
- A. Weight loss of 2 lb in a week
- B. Swelling of the extremities
- C. Episodes of dyspnea
- D. Heart rate increased by about 10 bpm
- E. Fainting
Correct Answer: B,C,E
Rationale: The primary health care provider should be notified if the client experiences a heart rate of 20 bpm or more above the normal rate, rapid weight gain of 5 lb or more; unusual swelling of the extremities, face, or abdomen, dyspnea; angina; severe indigestion; or fainting.
When discussing the use of antianginal drugs for the treatment of cardiac disease, a nurse would expect to include which of the following? Select all that apply.
- A. Relief of pain of acute anginal attacks
- B. Reduction in serum triglyceride levels
- C. Prevention of anginal attacks
- D. Elevation of high-density lipoproteins (HDLs)
- E. Treatment of chronic stable angina pectoris
Correct Answer: A,C,E
Rationale: Antianginal drugs are used to relieve the pain of acute anginal attacks, prevent anginal attacks, and treat chronic stable angina pectoris. Antianginals have no effect on HDLs or triglycerides.
A client has a nursing diagnosis of Acute Pain related to angina. When teaching a client about antianginal drugs, the nurse would explain which of the following about pain relief? Select all that apply.
- A. Pain will only occur during prolonged exercise.
- B. Pain may be less intense.
- C. Pain may not be completely relieved.
- D. Pain may be less frequent.
- E. Pain will worsen with continued use
Correct Answer: B,C,D
Rationale: Although some clients experience complete angina pain relief, it may not be completely relieved in all clients. In some clients pain may be less intense or less frequent or may only occur during prolonged exercise.
When instructing the client on how to use the prescribed nitroglycerin ointment, the nurse would tell the client to use which of the following to determine the amount?
- A. A teaspoon
- B. Length of a finger
- C. Paper applicator
- D. The size of the previous dose
Correct Answer: C
Rationale: The topical ointment is supplied with a paper applicator to determine the amount of drug to be used. No other method is appropriate.
Which of the following does the nurse need to include as part of the physical assessment of a client with anginal pain? Select all that apply.
- A. Blood pressure
- B. Apical pulse
- C. Oxygen saturation
- D. Radial pulse
- E. Respiratory rate
Correct Answer: A,B,D,E
Rationale: The nurse's physical assessment of a client with angina should include blood pressure, respiratory rate, and apical and radial pulses. The physical assessment may also include weight, inspection of the extremities for edema, and auscultation of the lungs, depending on the type of heart failure.