A patient is diagnosed with hypertension.
What is the initial recommendation for this patient likely to be?

Class IV antidysrhythmics or calcium channel blockers decrease the flow of calcium ions into cardiac and vascular smooth muscle cells, thus decreasing heart rate and contractions.By reducing the calcium influx, they also decrease the slope of phase 0 and 4 and prolong phase 2 of the cardiac action potential.This results in vasodilation, reduced myocardial oxygen demand, and decreased conduction through the AV node.

Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather cause vasodilation.

Choice C is wrong because calcium channel blockers do not decrease refractory period, but rather prolong it by extending phase 2 of the cardiac action potential.

Choice D is wrong because calcium channel blockers do not increase heart rate, but rather decrease it by slowing down the pacemaker activity and AV nodal conduction.

Normal ranges for heart rate are 60 to 100 beats per minute, and for blood pressure are 120/80 mmHg or lower.

Taking a loop diuretic with supper is not advisable because it can cause nocturia, which is the need to urinate frequently at night. This can disrupt sleep and affect quality of life.Loop diuretics should be taken in the morning or early afternoon to avoid this problem.

Choice A is wrong because weighing oneself each day before breakfast is a good way to monitor fluid balance and detect any signs of fluid retention or dehydration.This can help adjust the dose of the loop diuretic as needed.

Choice B is wrong because contacting the healthcare provider if shortness of breath returns is a sensible precaution and indicates awareness of the symptoms of worsening heart failure.Shortness of breath is caused by fluid accumulation in the lungs, which loop diuretics help to prevent or reduce.

Choice C is wrong because having a banana with breakfast every morning is a good source of potassium, which can help prevent hypokalemia, a common side effect of loop diuretics.Loop diuretics increase the excretion of potassium in the urine, which can lead to low blood levels of potassium and cause muscle weakness, cramps, fatigue, arrhythmias, and increased sensitivity to digoxin.