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 ["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.
Correct Answer is B
Explanation
A) Platelets 190,000/mm³:
A platelet count of 190,000/mm³ is within the normal range (typically 150,000 to 450,000/mm³). This result does not indicate a need for immediate concern in the context of warfarin therapy.
B) PT 45 seconds:
A prothrombin time (PT) of 45 seconds is significantly elevated. This indicates that the blood's clotting ability is excessively prolonged, which could increase the risk of bleeding complications in a client taking warfarin. Immediate notification to the provider is necessary to potentially adjust the dosage or investigate further.
C) Hgb 16 g/dL:
A hemoglobin level of 16 g/dL is within the normal range for adults (typically 13.8 to 17.2 g/dL for males and 12.1 to 15.1 g/dL for females). This result does not warrant concern in relation to warfarin therapy.
D) Hct 44%:
A hematocrit level of 44% is within the normal range (generally 40% to 50% for males and 36% to 48% for females). This result does not indicate an issue related to warfarin therapy.
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