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 B

Explanation

A) "I've had a backache for several days."
A backache is not typically associated with digoxin toxicity. This symptom is more likely related to musculoskeletal issues rather than an adverse effect of digoxin.

B) "I feel nauseated and have no appetite."
Nausea and loss of appetite are common symptoms of digoxin toxicity. Digoxin can cause gastrointestinal disturbances as part of its adverse effects, and these symptoms are important indicators that the medication levels may be too high.

C) "I am urinating more frequently."
Increased urination is not an adverse effect of digoxin itself but may be a result of the diuretic effect of other medications often used in conjunction with digoxin for heart failure. It is not typically a direct sign of digoxin toxicity.

D) "I can walk a mile a day."
The ability to walk a mile a day indicates that the client is experiencing functional improvement, not adverse effects. Digoxin is used to improve symptoms of heart failure, and this statement suggests that the medication may be having a beneficial effect.

Correct Answer is ["8.33"]

Explanation

Calculating the IV Infusion Rate

Problem: Infuse 150 mL of D5W over 3 hours using a tubing with a drop factor of 10 gtt/mL.

Steps:

Convert hours to minutes:

3 hours x 60 minutes/hour = 180 minutes

Calculate the total drops:

150 mL x 10 gtt/mL = 1500 gtt

Calculate the drops per minute:

1500 gtt / 180 minutes = 8.33 gtt/min

The nurse should set the manual IV infusion to deliver 8 gtt/min. (Rounding 8.33 to the nearest whole number.)

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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 caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?

Correct Answer is B

Explanation

Correct Answer is ["8.33"]

Explanation

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