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When teaching a client about the prescribed clonidine transdermal medication, which of the following would the nurse most likely include? Select all that apply.
- A. A new patch is applied daily.
- B. If the patch loosens, a new patch should be applied
- C. The use of the adhesive overlay is not necessary
- D. A different body area should be selected for each application.
- E. The patch should be applied to a hairless area
Correct Answer: D,E
Rationale: The patch is applied to a hairless area of intact skin on the upper arm or torso; the patch is kept in place for 7 days. The adhesive overlay is applied directly over the system to ensure the patch remains in place for the required time. A different body area is selected for each application. If the patch loosens before 7 days, the edges can be reinforced with nonallergenic tape.
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A client with hypertension has a fungal infection and has been prescribed fluconazole for the fungal infection and losartan for hypertension. The nurse would be alert for which of the following?
- A. Increased risk of adverse effects of losartan
- B. Increased risk of hypersensitivity reaction
- C. Decreased hypotensive effect of losartan
- D. Increased risk of hypoglycemia
Correct Answer: A
Rationale: Increased risk of antihypertensive effects and adverse reactions are associated with the concomitant use of fluconazole and losartan. Decreased hypotensive effect of losartan is seen with use of indomethacin and does not occur with the concomitant use of these drugs. Increased risk of hypoglycemia and increased risk of hypersensitivity do not occur with the concomitant use of these drugs.
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.
When educating a group of nursing students on the mechanism of action of angiotensin-converting enzyme inhibitor (ACEI) drugs, the instructor identifies which of the following as the action brought about by aldosterone?
- A. Inhibits renin secretion
- B. Causes sodium and water retention
- C. Causes excess potassium retention
- D. Promotes angiotensin I conversion
Correct Answer: B
Rationale: Aldosterone causes retention of sodium and water. This in turn causes a rise in blood pressure. ACEIs act by inhibiting the conversion of angiotensin I to angiotensin II. Aldosterone does not inhibit the release of renin and is not involved in the retention of potassium. Angiotensin-converting enzymes, and not aldosterone, are involved in the conversion of angiotensin I to angiotensin II.
When providing care to a client with hypertension who is receiving antihypertensive therapy, which assessment would be the highest priority?
- A. Pain rating
- B. Blood pressure monitoring
- C. Weight measurement
- D. Complaints of adverse reactions
Correct Answer: B
Rationale: Although assessing for pain, measuring weight, and assessing for complaints of adverse reactions are important, monitoring the client's blood pressure would have the highest priority because the drug therapy regimen may need to be adjusted or changed if the client's response is inadequate.
When teaching a client newly diagnosed with hypertension, which instructions would the nurse incorporate into the teaching plan? Select all that apply.
- A. Lose weight.
- B. Stop smoking.
- C. Reduce stress.
- D. Decrease exercise.
- E. Increase sodium intake.
Correct Answer: A,B,C
Rationale: Nonpharmacologic management of hypertension should include weight loss, stress reduction, regular aerobic exercise, smoking cessation, moderation of alcohol, and decreased sodium intake.