Nokea
Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?
- A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
- B. To decrease blood pressure
- C. To increase heart rate
- D. To provide antiplatelet activity in patients who cannot tolerate aspirin
Correct Answer: D
Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.
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When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?
- A. "Your chest pain should go away with one tablet."
- B. "If your chest pain doesn't go away after three tablets, call 911; you might be having a heart attack."
- C. "If your chest pain doesn't go away with one tablet, you can repeat the dose as many times as you need to."
- D. "Be sure to call 911 before you take any tablets."
Correct Answer: B
Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.
The client asks the nurse about common side effects of calcium channel blockers. What should the nurse include in client teaching?
- A. Headache
- B. Constipation
- C. Epistaxis
- D. Dysuria
Correct Answer: A
Rationale: One of the common side effects of calcium channel blockers is a headache. This is important information for the nurse to include in client teaching as it helps the client understand potential adverse effects of the medication. Constipation, epistaxis, and dysuria are not typically associated with calcium channel blockers.
The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?
- A. Decrease salt and fat intake and limit alcohol intake.
- B. There are no dietary restrictions for a person diagnosed with angina.
- C. Limit smoking and increase protein and sugar intake.
- D. Increase fruits, vegetables, and foods high in cholesterol.
Correct Answer: A
Rationale: The correct answer is to decrease salt and fat intake and limit alcohol intake. These dietary changes can help manage angina by reducing the workload on the heart and preventing further plaque buildup in the arteries. Choices B, C, and D are incorrect as dietary restrictions for angina typically involve reducing salt, fat, and alcohol intake, rather than increasing sugar or cholesterol intake.
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.
A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?
- A. Reflex tachycardia
- B. Dizziness
- C. Hyponatremia
- D. Hypotension
Correct Answer: C
Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.