A client who receives multiple antihypertensive medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse's decision to hold the client's scheduled antihypertensive medications?
Increased urinary clearance of the multiple medications has produced diuresis and lowered the blood pressure.
The synergistic effect of the multiple medications has resulted in drug toxicity and hypotension.
The antagonistic interaction among the various blood pressure medications has reduced their effectiveness.
The additive effect of multiple medications has caused the blood pressure to drop too low.
The Correct Answer is D
Choice A reason: Increased urinary clearance of the multiple medications is not the cause of the client's syncope. Diuresis is a common side effect of some antihypertensive medications, such as diuretics, but it does not lower the blood pressure to a dangerous level. The nurse should monitor the client's fluid and electrolyte balance and urine output, but it is not the priority action in this situation.
Choice B reason: The synergistic effect of the multiple medications is not the cause of the client's syncope. Synergism is when two or more drugs work together to produce a greater effect than the sum of their individual effects. This can be beneficial or harmful, depending on the drugs and the doses. The nurse should check the client's medication history and avoid prescribing drugs that have a negative synergistic effect, but it is not the most likely explanation for the client's hypotension.
Choice C reason: The antagonistic interaction among the various blood pressure medications is not the cause of the client's syncope. Antagonism is when two or more drugs work against each other to reduce or cancel out their effects. This can decrease the effectiveness of the treatment and increase the risk of complications. The nurse should check the client's medication history and avoid prescribing drugs that have a negative antagonistic effect, but it is not the most likely explanation for the client's hypotension.
Choice D reason: The additive effect of multiple medications is the most likely cause of the client's syncope. Additivity is when two or more drugs have a similar effect and their combined effect is equal to the sum of their individual effects. This can lower the blood pressure too much and cause symptoms such as dizziness, fainting, and shock. The nurse should hold the client's scheduled antihypertensive medications and notify the healthcare provider. The nurse should also monitor the client's vital signs, level of consciousness, and perfusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Diarrhea is not a contraindication for phenylephrine, which is a decongestant that reduces swelling and mucus in the nasal passages. However, the nurse should monitor the client's fluid and electrolyte balance and provide adequate hydration.
Choice B reason: Bronchitis is not a contraindication for phenylephrine, which may help relieve some of the symptoms of bronchitis, such as nasal congestion and cough. However, the nurse should also encourage the client to use other measures, such as steam inhalation, expectorants, and rest.
Choice C reason: Hypertension is a contraindication for phenylephrine, which can increase blood pressure and heart rate by constricting blood vessels. The nurse should report this condition to the healthcare provider and withhold the medication until further orders.
Choice D reason: Edema is not a contraindication for phenylephrine, which does not affect fluid retention or distribution. However, the nurse should assess the cause of edema and monitor the client's weight and urine output.
Correct Answer is C
Explanation
Choice A reason: Providing a heating pad to the client may provide some temporary relief, but it does not address the underlying cause of the neck discomfort, which is likely due to extrapyramidal side effects (EPS) of the antipsychotic medication.
Choice B reason: Obtaining a prescription for physical therapy services may be beneficial for the client's overall health and well-being, but it is not the best intervention for the acute problem of neck discomfort. Physical therapy may also require a referral and a waiting period, which would delay the relief for the client.
Choice C reason: Giving a PRN prescription for benztropine is the best intervention for the nurse to implement, as benztropine is an anticholinergic medication that can counteract the EPS of the antipsychotic medication. Benztropine can reduce the muscle stiffness and spasms that cause the neck discomfort.
Choice D reason: Obtaining an extra pillow for the client to use at night may help the client sleep better, but it does not address the neck discomfort during the day. It also does not treat the EPS of the antipsychotic medication, which may worsen over time.
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