A nurse is monitoring a client who is taking captopril and has developed swelling of the lips and tongue. Which of the following actions should the nurse plan to take to manage this adverse medication reaction?

Administer a dose of subcutaneous epinephrine.

Advise the client not to consume grapefruit products.

Place warm compresses on both sides of the client's face.

Swab the client's oral mucosa with nystatin suspension.

Answer and Explanation

The Correct Answer is A

A. Administer a dose of subcutaneous epinephrine.: The swelling of the lips and tongue is indicative of angioedema, a serious adverse reaction to captopril. Epinephrine is the first-line treatment for severe allergic reactions or angioedema to quickly counteract the swelling and prevent airway obstruction.

B. Advise the client not to consume grapefruit products.: Grapefruit can interact with some medications, but it is not related to the management of angioedema. This action would be more relevant for drugs metabolized by CYP3A4, not specifically for angioedema.

C. Place warm compresses on both sides of the client's face.: Warm compresses are not appropriate for angioedema and may not address the underlying issue. This action does not manage the immediate, potentially life-threatening reaction caused by captopril.

D. Swab the client's oral mucosa with nystatin suspension.: Nystatin is used for fungal infections of the oral mucosa, not for angioedema. This action does not address the adverse reaction related to captopril.

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Correct Answer is B

Explanation

A. Consume 2,800 calories daily during the third trimester.: The caloric needs during pregnancy vary, but 2,800 calories might be excessive for someone with gestational diabetes. The focus should be on maintaining a balanced diet that helps control blood glucose levels rather than meeting a specific caloric target.

B. Distribute daily calories among three meals and three snacks.: Distributing calories throughout the day with balanced meals and snacks can help manage blood glucose levels and prevent significant spikes or drops. This approach is commonly recommended for managing gestational diabetes.

C. Maintain a blood glucose level between 100 to 130 mg/dL before meals.: The target for fasting blood glucose levels in gestational diabetes is generally less than 95 mg/dL. Maintaining blood glucose levels within this range is crucial to manage the condition effectively.

D. Restrict daily carbohydrate intake to 60% of total caloric intake.: Carbohydrate intake should be managed carefully, but it is not typically restricted to a specific percentage like 60%. Instead, a balanced approach with an emphasis on complex carbohydrates and monitoring individual responses is recommended.

A. "Limit crossing your legs at your knees to 30 minutes at a time." B. "Elevate the head of the bed when sleeping at night." C. "Wash your graduated compression stockings in the washing machine." D. "Put on your graduated compression stockings before getting out of bed."

Correct Answer is D

Explanation

A) Limit crossing your legs at your knees to 30 minutes at a time: Crossing the legs at the knees can restrict blood flow and increase venous pressure, which is detrimental to clients with venous insufficiency. It's generally advised to avoid crossing legs altogether rather than limiting it to 30 minutes.

B) Elevate the head of the bed when sleeping at night: Elevating the head of the bed does not significantly aid in improving venous return from the legs. Elevating the legs instead helps reduce venous pressure and promotes better circulation, which is more beneficial for venous insufficiency.

C) Wash your graduated compression stockings in the washing machine: Washing compression stockings in a washing machine can damage their elasticity and effectiveness. It's better to hand wash them and let them air dry to maintain their compression properties.

D) Put on your graduated compression stockings before getting out of bed: Putting on compression stockings before getting out of bed helps to prevent blood from pooling in the legs. This maximizes their effectiveness in reducing edema and promoting venous return throughout the day.

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A nurse is monitoring a client who is taking captopril and has developed swelling of the lips and tongue. Which of the following actions should the nurse plan to take to manage this adverse medication reaction?

Nursing Test Bank

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