A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide?
Expect to gain weight while taking this medication.
Do not use salt substitutes while taking this medication.
Count your pulse rate before taking the medication.
Take the medication with food.
The Correct Answer is B
Choice A reason: Expecting to gain weight while taking this medication is not a correct instruction, as it may discourage the client from adhering to the treatment and may worsen the hypertension. Captopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers the blood pressure by preventing the formation of angiotensin II, a potent vasoconstrictor. Captopril does not cause significant weight gain, but it may cause fluid retention or edema in some cases. The nurse should advise the client to monitor the weight daily and report any sudden or excessive increase to the provider.
Choice B reason: Not using salt substitutes while taking this medication is a correct instruction, as it may prevent the risk of hyperkalemia, a potentially life-threatening condition. Captopril may increase the potassium level in the blood by reducing the secretion of aldosterone, a hormone that regulates the sodium and potassium balance. Salt substitutes may contain potassium chloride, which may further elevate the potassium level. The nurse should advise the client to avoid salt substitutes and high-potassium foods, such as bananas, oranges, or tomatoes, and to have regular blood tests to check the electrolyte levels.
Choice C reason: Counting the pulse rate before taking the medication is not a necessary instruction, as it may not reflect the effect of the medication on the blood pressure. Captopril does not affect the heart rate significantly, but it may lower the blood pressure too much, especially in the first few weeks of treatment or after a dose increase. This may cause hypotension, dizziness, or fainting. The nurse should advise the client to monitor the blood pressure regularly and report any symptoms of hypotension to the provider.
Choice D reason: Taking the medication with food is not a correct instruction, as it may reduce the absorption and effectiveness of the medication. Captopril should be taken on an empty stomach, at least one hour before or two hours after a meal, to ensure optimal bioavailability. The nurse should advise the client to take the medication at the same time every day and to avoid skipping or doubling the doses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Warfarin PO is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a slow onset of action and requires frequent monitoring of the INR (international normalized ratio). Warfarin may be used for long-term anticoagulation, but it is not effective for preventing the formation of new clots.
Choice B reason: Enoxaparin subcutaneous is a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a rapid onset of action and does not require frequent monitoring of the coagulation status. Enoxaparin is a low-molecular-weight heparin that inhibits the formation of thrombin and prevents the growth of existing clots.
Choice C reason: Aspirin PO is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a weak anticoagulant effect and may increase the risk of bleeding. Aspirin is an antiplatelet agent that inhibits the aggregation of platelets and prevents the formation of arterial clots, but it is not effective for preventing venous clots.
Choice D reason: Heparin infusion is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it requires continuous intravenous administration and frequent monitoring of the aPTT (activated partial thromboplastin time). Heparin is an unfractionated heparin that inhibits the formation of thrombin and prevents the growth of existing clots, but it has a narrow therapeutic window and a high risk of bleeding.
Correct Answer is A
Explanation
Choice A reason: Using an electric razor while on warfarin is the correct instruction. Warfarin is an anticoagulant that inhibits the formation of blood clots and prolongs the bleeding time. Using an electric razor can reduce the risk of cuts and bleeding while shaving. The client should avoid using sharp objects or instruments that can cause injury or trauma.
Choice B reason: Doubling the dose of warfarin if a dose is missed is not the correct instruction. This is a dangerous and potentially fatal advice, as it can cause overdose and severe bleeding. The client should take the missed dose as soon as possible, unless it is close to the next scheduled dose, in which case the client should skip the missed dose and resume the regular dosing schedule. The client should never take extra doses or change the dose without consulting the provider.
Choice C reason: Mild nosebleeds being common during initial treatment is not the correct instruction. This is a false and misleading statement, as nosebleeds are not a normal or expected side effect of warfarin therapy. Nosebleeds can indicate bleeding problems or complications, such as thrombocytopenia, which is a low platelet count. The client should report any nosebleeds or other signs of bleeding, such as bruising, petechiae, hematuria, or melena, to the provider immediately.
Choice D reason: Increasing fiber intake to reduce the adverse effect of constipation is not the correct instruction. This is an irrelevant and unnecessary recommendation, as constipation is not a common or serious adverse effect of warfarin therapy. Constipation can be caused by many factors, such as diet, hydration, activity, or medication. The client should maintain a balanced and consistent diet, drink plenty of fluids, and exercise regularly to prevent constipation. The client should also avoid foods that are high in vitamin K, such as green leafy vegetables, as they can interfere with the effect of warfarin.
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