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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A) Enteral:
Enteral routes, such as oral or rectal, involve absorption through the gastrointestinal tract. This process generally takes longer due to factors such as digestion and metabolism in the liver before reaching systemic circulation.

B) Intramuscular:
Intramuscular injections are absorbed faster than subcutaneous injections but slower than intravenous administration. The absorption rate can be influenced by factors such as blood flow to the muscle and the drug's formulation.

C) Intravenous:
The intravenous (IV) route provides the fastest rate of absorption because the medication is delivered directly into the bloodstream, bypassing absorption barriers and ensuring immediate availability for systemic effect. This route is often used for emergency situations and precise dosing.

D) Topical:
Topical administration involves applying medication directly to the skin or mucous membranes. This route has a slower rate of absorption compared to intravenous administration due to the need for the medication to pass through the skin or mucosal barriers before entering systemic circulation.

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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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.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a class about routes of medication administration. The nurse should include that which of the following routes has the fastest rate of absorption?

Correct Answer is C

Explanation

A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.2"]

Explanation

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