A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.)
Duloxetine
Furosemide
Telmisartan
Atorvastatin
Clopidogrel
Correct Answer : A,B,C
A) Duloxetine: Duloxetine, an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor), is commonly used for depression and chronic pain. It can cause orthostatic hypotension, especially in older adults, due to its effects on norepinephrine, which can lead to blood pressure fluctuations upon standing.
B) Furosemide: Furosemide is a loop diuretic that increases urine output, leading to a decrease in blood volume. This reduction in blood volume can result in orthostatic hypotension, particularly when the client changes positions quickly, such as moving from lying down to standing.
C) Telmisartan: Telisartan is an angiotensin II receptor blocker (ARB) used to treat hypertension. It can cause vasodilation and a reduction in blood pressure, which may lead to orthostatic hypotension, especially in older adults who are more sensitive to blood pressure changes.
D) Atorvastatin: Atorvastatin, a statin used to lower cholesterol, does not typically cause orthostatic hypotension. Its primary action is on lipid levels rather than blood pressure, making it less likely to contribute to this condition.
E) Clopidogrel: Clopidogrel is an antiplatelet medication that reduces the risk of blood clots. It does not generally affect blood pressure or cause orthostatic hypotension, as its mechanism of action is related to inhibiting platelet aggregation rather than influencing vascular tone or fluid balance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Discard the medication:
The safest action is to discard the medication. Medications past their expiration date may not be effective and could potentially be unsafe. Using expired medications can pose risks, and discarding them ensures that the client is not exposed to potentially compromised treatments.
B) Give the medication:
Administering expired medication is not appropriate as it could be ineffective or harmful. The expiration date indicates that the medication may no longer be guaranteed to work as intended or might have degraded, making it unsafe to give.
C) Return the medication to the pharmacy:
Returning expired medication to the pharmacy is not a standard practice. The medication should be disposed of according to facility protocols, and the pharmacy should be notified of the issue so they can take appropriate actions.
D) Notify the provider:
While notifying the provider is important if there are issues with medication availability or alternatives, the immediate action regarding the expired medication itself is to discard it. The provider can be informed as part of addressing the medication issue and determining the next steps.
Correct Answer is ["0.2"]
Explanation
Calculating the Morphine Sulfate Dose:Problem: Administer 2 mg of morphine sulfate IV bolus. The available concentration is 10 mg/mL.
Steps:
Set up a proportion:
We want to find the number of milliliters (mL) needed.
We know the desired dose (2 mg) and the concentration of the medication (10 mg/mL).
Proportion:
x mL / 2 mg = 1 mL / 10 mg
Cross-multiply:
10x = 2
Solve for x:
x = 2 / 10
x = 0.2
Answer: The nurse should administer 0.2 mL of morphine sulfate per dose.
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