A nurse is reviewing the medication history of a client who has hypertension and is prescribed a calcium channel blocker. Which of the following medications should the nurse instruct the client to avoid? (Select all that apply.)

The nurse should instruct the client to avoid grapefruit juice and St. John’s wort when taking a calcium channel blocker.

Here is why:

• Grapefruit juice can increase the blood levels of calcium channel blockers, which can lead to adverse effects such as hypotension, bradycardia, and edema.

The normal blood pressure range is 90/60 mmHg to 120/80 mmHg, and the normal heart rate range is 60 to 100 beats per minute.

• St.John’s wort can decrease the effectiveness of calcium channel blockers by inducing their metabolism in the liver.

This can reduce the therapeutic effect of lowering blood pressure and preventing angina.

• Ibuprofen, digoxin, and warfarin are not contraindicated with calcium channel blockers, but they should be used with caution and monitored closely for potential interactions.

Ibuprofen can increase the risk of bleeding when taken with warfarin, digoxin can increase the risk of arrhythmias when taken with calcium channel blockers, and warfarin can increase the risk of bleeding when taken with calcium channel blockers.

Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure by increasing urine output. However, it also causes potassium loss, which can lead to muscle weakness and fatigue.Therefore, the client should consume foods that are rich in potassium, such as bananas, oranges, potatoes, and spinach.

Choice A is wrong because drinking more fluids can increase blood volume and blood pressure, which is not desirable for a client who has hypertension.Dehydration is not a common side effect of hydrochlorothiazide.

Choice C is wrong because hydrochlorothiazide does not affect blood sugar levels directly. However, it can interact with some antidiabetic medications and increase the risk of hypoglycemia.Therefore, the client should monitor blood sugar levels regularly if taking both medications.

Choice D is wrong because hydrochlorothiazide does not increase sensitivity to sunlight. However, it can cause photosensitivity reactions in some clients, such as rash, itching, or redness of the skin. Therefore, the client should use sunscreen and wear protective clothing when exposed to sunlight.