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.

Answer and Explanation

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.

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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.

A. Administer both prescribed medications as scheduled. B. Hold the calcium carbonate, but administer the calcitriol as scheduled. C. Hold both medications until contacting the healthcare provider. D. Hold the calcitriol, but administer the calcium carbonate as scheduled.

Correct Answer is C

Explanation

Choice A reason: Administering both prescribed medications as scheduled is not the appropriate action in this situation. The client's total calcium level is above the normal range of 9 to 10.5 mg/dL (2.25 to 2.62 mmol/L), indicating hypercalcemia. Hypercalcemia is a serious condition that can cause nausea, vomiting, constipation, confusion, kidney stones, and cardiac arrhythmias. Giving more calcitriol and calcium carbonate would worsen the client's condition and increase the risk of complications.

Choice B reason: Holding the calcium carbonate, but administering the calcitriol as scheduled is not the appropriate action in this situation. Calcium carbonate is a supplement that provides extra calcium to the body. Calcitriol is a synthetic form of vitamin D that helps the body absorb calcium from the intestines and kidneys. Both medications can increase the blood calcium level and cause hypercalcemia. The nurse should not give either medication without consulting the healthcare provider.

Choice C reason: Holding both medications until contacting the healthcare provider is the best action in this situation. The nurse should recognize that the client's total calcium level is dangerously high and report it to the healthcare provider as soon as possible. The healthcare provider may order to stop or adjust the doses of calcitriol and calcium carbonate, and prescribe other treatments to lower the blood calcium level, such as intravenous fluids, diuretics, or bisphosphonates.

Choice D reason: Holding the calcitriol, but administering the calcium carbonate as scheduled is not the appropriate action in this situation. Calcium carbonate is a supplement that provides extra calcium to the body. Giving more calcium carbonate to a client with hypercalcemia would increase the blood calcium level even more and cause more harm. The nurse should not give any medication that can raise the blood calcium level without consulting the healthcare provider.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with nasal congestion receives a prescription for phenylephrine 10 mg by mouth every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?

Correct Answer is C

Explanation

After administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?

Correct Answer is C

Explanation

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