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."
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Milk:
Milk is not known to interact significantly with verapamil. Therefore, there's no need for the client to avoid consuming milk while taking this medication.
B) Orange juice:
Orange juice does not typically interact with verapamil. However, calcium-containing foods and beverages, including orange juice, may reduce the absorption of verapamil when taken simultaneously. While the interaction is not severe, it's advisable for clients to separate the administration of verapamil from calcium-rich foods and beverages to optimize absorption.
C) Grapefruit juice:
This is the correct answer. Grapefruit juice contains compounds that inhibit the activity of cytochrome P450 enzymes, particularly CYP3A4, which are involved in the metabolism of many medications, including verapamil. Consuming grapefruit juice while taking verapamil can lead to elevated blood levels of the medication, increasing the risk of side effects and toxicity. Therefore, clients should avoid grapefruit juice while on verapamil therapy.
D) Coffee:
Coffee does not typically interact with verapamil. However, caffeine-containing beverages like coffee may exacerbate certain side effects of verapamil, such as dizziness or palpitations, due to their stimulant effects. Clients may be advised to limit caffeine intake or consume coffee in moderation while taking verapamil.
Correct Answer is A
Explanation
A) STAT administration of atropine:
This is the correct answer. Atropine is a cholinergic antagonist that can increase heart rate by blocking the action of acetylcholine on cardiac muscarinic receptors. In cases of severe bradycardia, especially if associated with symptoms such as dizziness, syncope, or hypotension, atropine is often administered to increase heart rate and improve cardiac output. The dose of atropine and frequency of administration depend on the severity of bradycardia and the clinical response.
B) Administration of activated charcoal:
Activated charcoal is used in cases of overdose or poisoning to absorb ingested toxins and prevent their absorption into the bloodstream. However, in this scenario, where the primary concern is bradycardia resulting from cholinesterase inhibitor (donepezil) toxicity, activated charcoal would not be effective in reversing the bradycardic effects of the medication.
C) Hemodialysis:
Hemodialysis is a renal replacement therapy used to remove toxins and waste products from the blood in individuals with kidney failure. While hemodialysis may be indicated in cases of severe drug overdose or poisoning to enhance toxin elimination, it is not typically used as a first-line intervention for bradycardia associated with cholinesterase inhibitor toxicity.
D) Intravenous administration of pseudoephedrine:
Pseudoephedrine is a sympathomimetic drug that acts as a vasoconstrictor and can increase heart rate and blood pressure. While it may be used to treat bradycardia in some cases, such as severe symptomatic bradycardia unresponsive to atropine, it is not the first-line treatment for cholinesterase inhibitor toxicity-induced bradycardia. Atropine is preferred due to its direct antagonism of muscarinic receptors in the heart.
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