Nokea
The healthcare professional is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the healthcare professional to question administering this drug?
- A. Respirations 12 breaths per minute
- B. Pulse 52 beats per minute
- C. Blood pressure 134/72
- D. Oxygen saturation 95%
Correct Answer: B
Rationale: Atenolol is a beta-blocker medication that can lower heart rate. A pulse of 52 beats per minute is relatively low and administering atenolol could further decrease the heart rate, potentially leading to bradycardia. Monitoring the pulse rate and holding the medication if the pulse is below the prescribed parameters is crucial to prevent adverse effects such as bradycardia and hypotension.
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What is the first type of medication prescribed to prevent angina pain for a client?
- A. Beta blockers
- B. Alpha blockers
- C. Calcium channel blockers
- D. Organic nitrates
Correct Answer: A
Rationale: Beta blockers are the first-line medication prescribed to prevent angina pain. They work by reducing the heart rate and blood pressure, decreasing the heart's demand for oxygen. This helps in preventing angina attacks by improving blood flow to the heart. Alpha blockers, calcium channel blockers, and organic nitrates are also used in angina treatment but are typically considered after beta blockers.
The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?
- A. "I will check my weight regularly for any gain or loss."
- B. "I'll make sure to take my high blood pressure medications."
- C. "I am attending a smoking cessation class."
- D. "As long as I exercise, stress at my job will not bother me."
Correct Answer: D
Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.
The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?
- A. Atenolol (Tenormin)
- B. Nitroglycerin (Nitrostat)
- C. Sildenafil (Viagra)
- D. Ranolazine (Ranexa)
Correct Answer: D
Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.
A client has been prescribed diltiazem (Cardizem) and asks the nurse what type of drug this is. Which response by the nurse is most appropriate?
- A. "A beta blocker."
- B. "A sodium channel blocker."
- C. "An alpha blocker."
- D. "A calcium channel blocker."
Correct Answer: D
Rationale: Diltiazem (Cardizem) belongs to the class of drugs known as calcium channel blockers. These medications work by blocking calcium from entering the muscle cells of the heart and blood vessels, leading to relaxation of the blood vessels and reduced workload on the heart. This helps in lowering blood pressure and improving blood flow. It is crucial for the nurse to provide accurate information to the client about the type of drug prescribed to ensure understanding and compliance with the treatment plan.
Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?
- A. 45 minutes to 18 hours
- B. 30 minutes to 12 hours
- C. 90 minutes to 36 hours
- D. 60 minutes to 24 hours
Correct Answer: B
Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.