Nokea
The nurse is caring for a patient with hypertension and has a prescription for propranolol. Which of the following assessment findings should the nurse report to the health care provider before administering this medication?
- A. Asthma
- B. Peptic ulcer disease
- C. Alcohol dependency
- D. Myocardial infarction
Correct Answer: A
Rationale: Nonselective β-adrenergic blockers can cause bronchospasm, putting the patient with a history of asthma at high risk. β-adrenergic blockers will have no effect on the patient's peptic ulcer disease or alcohol dependency. β-adrenergic blocker therapy is recommended after MI.
You may also like to solve these questions
Which of the following nursing actions should the nurse take first in order to assist a patient with newly diagnosed stage 1 hypertension in making needed dietary changes?
- A. Have the patient record dietary intake for 3 days.
- B. Give the patient a detailed list of low-sodium foods.
- C. Teach the patient about foods that are high in sodium.
- D. Help the patient make an appointment with a dietitian.
Correct Answer: A
Rationale: The initial nursing action should be assessment of the patient's baseline dietary intake through a 3-day diet history. The other actions may be appropriate, but assessment of the patient's baseline should occur first.
The nurse is caring for a patient with hypertension and has just administered the initial dose of labetalol. Which of the following actions should the nurse take?
- A. Encourage oral fluids to prevent dry mouth or dehydration.
- B. Instruct the patient to ask for help if heart palpitations occur.
- C. Ask the patient to request assistance when getting out of bed.
- D. Teach the patient that headaches may occur with this medication.
Correct Answer: C
Rationale: Labetalol decreases sympathetic nervous system activity by blocking both ?±- and β-adrenergic receptors, leading to vasodilation and a decrease in heart rate, which can cause severe orthostatic hypotension. Heart palpitations, dehydration, and headaches are possible adverse effects of other antihypertensives.
The nurse is assessing a patient who is being investigated for possible white coat hypertension. Which of the following actions should the nurse implement first?
- A. Schedule the patient for frequent BP checks in the clinic.
- B. Instruct the patient about the need to decrease stress levels.
- C. Tell the patient how to self-monitor and record BPs at home.
- D. Teach the patient about ambulatory blood pressure monitoring.
Correct Answer: C
Rationale: Having the patient self-monitor BPs at home will provide a reliable indication about whether the patient has hypertension. Frequent BP checks in the clinic are likely to be high in a patient with white coat hypertension. Ambulatory blood pressure monitoring may be used if the data from self-monitoring is unclear. Although elevated stress levels may contribute to hypertension, instructing the patient about this is unlikely to reduce BP.
The nurse is caring for a patient who is experiencing a hypertensive crisis and is receiving IV labetalol. Which of the following time frequencies should the nurse assess the patients' blood pressure and pulse during the initial administration of this medication?
- A. 2-3 minutes
- B. 5-10 minutes
- C. 15-30 minutes
- D. Hourly
Correct Answer: A
Rationale: Administered intravenously, the drugs have a rapid (within seconds to minutes) onset of action. The patient's BP and pulse should be taken every 2-3 minutes during the initial administration of these drugs.
The nurse is caring for a patient who has just diagnosed with hypertension and has a new prescription for captopril. Which of the following information is important to include when teaching the patient?
- A. Check BP daily before taking the medication.
- B. Increase fluid intake if dryness of the mouth is a problem.
- C. Include high-potassium foods such as bananas in the diet.
- D. Change position slowly to help prevent dizziness and falls.
Correct Answer: D
Rationale: The angiotensin-converting enzyme (ACE) inhibitors frequently cause orthostatic hypotension, and patients should be taught to change position slowly to allow the vascular system time to compensate for the position change. Increasing fluid intake may counteract the effect of the medication, and the patient is taught to use gum or hard candy to relieve dry mouth. The BP does not need to be checked at home by the patient before taking the medication. Because ACE inhibitors cause potassium retention, increased intake of high-potassium foods is inappropriate.