A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following Instructions should the nurse include?
"Reduce intake of potassium-rich foods."
"Take this medication before bedtime."
"Avoid grape juice.'
"Monitor for leg cramps."
The Correct Answer is D
A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.
B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.
C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.
D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Routinely exercise indoors:
Exercising indoors may be beneficial for individuals taking anticholinergic drugs to minimize the risk of heat-related complications. However, this option does not directly address the need to avoid extremes of temperature on exertion, which is crucial for preventing heat exhaustion and heat stroke. While indoor exercise can provide a controlled environment, it does not eliminate the risk entirely, especially if the indoor area is not adequately ventilated or air-conditioned.
B) Wear dark, warm clothing during the summer months:
Wearing dark, warm clothing during the summer months can exacerbate the risk of heat-related complications for individuals taking anticholinergic drugs. Dark clothing absorbs more heat from the sun, increasing body temperature, and warm clothing further contributes to heat retention. This option does not align with the goal of minimizing the risk of heat exhaustion and heat stroke.
C) Avoid extremes of temperature on exertion:
This is the correct answer. Avoiding extremes of temperature on exertion is essential for individuals taking anticholinergic drugs to reduce the risk of heat-related complications such as heat exhaustion and heat stroke. Exertion in hot environments can lead to excessive sweating and dehydration, further compromising thermoregulation. By avoiding extremes of temperature and moderating exertion, individuals can better regulate body temperature and minimize the risk of heat-related adverse effects.
D) Take frequent showers in the evenings and early mornings:
While taking frequent showers in the evenings and early mornings may help cool the body and reduce the risk of heat-related discomfort, it does not specifically address the need to avoid extremes of temperature on exertion. While personal hygiene practices are important, they should be supplemented with measures aimed at preventing heat-related complications, such as avoiding exertion in extreme temperatures. Therefore, this option does not fully meet the goal of minimizing the risk of heat exhaustion and heat stroke for individuals taking anticholinergic drugs.
Correct Answer is A
Explanation
A) Excretion:
This is the correct answer. The kidneys play a crucial role in the excretion of drugs and their metabolites from the body. After drugs undergo metabolism in the liver or other tissues, the resulting metabolites are often water-soluble and can be filtered by the kidneys into the urine. This process helps eliminate drugs and their byproducts from the body, preventing their accumulation and potential toxicity.
B) Absorption:
Absorption refers to the movement of drugs from the site of administration into the bloodstream. While the kidneys do not directly facilitate drug absorption, they may indirectly influence drug absorption by regulating blood flow and systemic circulation.
C) Metabolism:
Metabolism, or biotransformation, involves the enzymatic alteration of drugs into metabolites, which are often more water-soluble and easier to excrete. While the liver is the primary site of drug metabolism, the kidneys do not play a direct role in drug metabolism.
D) Distribution:
Distribution refers to the movement of drugs from the bloodstream to various tissues and organs in the body. While the kidneys do not directly influence drug distribution, changes in renal function can affect drug distribution by altering blood flow and plasma protein binding. However, the primary role of the kidneys in pharmacokinetics is excretion, not distribution.
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