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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.
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The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are contraindicated in clients with which of the following medical conditions? Select all that apply.
- A. Bilateral stenosis
- B. Angioedema
- C. Pregnancy
- D. Diabetes
- E. Hyperlipidemia
Correct Answer: A,B,C
Rationale: The use of ACEIs and ARBs is contraindicated if the client has impaired renal function, heart failure, salt or volume depletion, bilateral stenosis, angioedema, or as pregnant.
A client with hypertension comes to the clinic for a follow-up visit. Which of the following would be appropriate for the nurse to do when assisting the client in managing his hypertension? Select all that apply.
- A. Find local resources in the community for taking blood pressure.
- B. Teach client how to properly record weight and blood pressure.
- C. Schedule regular monitoring of weight and blood pressure.
- D. Schedule an appointment to see a cardiologist.
- E. Schedule an appointment to see a nephrologist.
Correct Answer: A,B,C
Rationale: In the ambulatory care setting, the nurse helps plan a schedule of regular monitoring of weight and blood pressure, finds local resources for taking blood pressure in the community, and teaches the client how to record weight and blood pressure readings.
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 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.
The nurse is providing care to a client being treated for a hypertensive emergency. Which of the following would be appropriate for the nurse to do?
- A. Take a blood pressure every 30 minutes.
- B. Alternate the arms for assessing the blood pressure and pulse.
- C. Continuously monitor the client's status.
- D. Measure the pulse rate every hour.
Correct Answer: C
Rationale: When the patient has severe hypertension, does not have the expected response to drug therapy, or is critically ill, continuous monitoring is performed. The blood pressure should be taken in the same arm and same position each time.