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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Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?
- A. Antiplatelets
- B. Beta-adrenergic blockers
- C. ACE inhibitors
- D. Calcium channel blockers
Correct Answer: B
Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.
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.
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 has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?
- A. NSAIDs
- B. Cardiac glycosides
- C. Beta blockers
- D. None of the above
Correct Answer: C
Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.
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.