A patient taking an angiotensin receptor blocker (AR) to control blood pressure is now complaining of muscle cramps which action will the nurse implement?

Review serum electrolytes

Request the patient's food diary

Place the patent on bed rest

Observing vital signs

Answer and Explanation

The Correct Answer is A

A. Review serum electrolytes: Muscle cramps can be associated with electrolyte imbalances, such as hypokalemia (low potassium levels), which can occur as a side effect of ARB medications. Therefore, reviewing the patient's serum electrolyte levels, including potassium, can help identify any abnormalities that may be contributing to the muscle cramps. If hypokalemia is present, appropriate interventions such as potassium supplementation or adjustment of the ARB dosage may be necessary to alleviate the muscle cramps.

B. Request the patient's food diary: While assessing the patient's food diary may provide information about their dietary habits and potential factors contributing to muscle cramps (such as dehydration or inadequate nutrient intake), it may not directly address the potential electrolyte imbalance associated with ARB use. Therefore, while obtaining a food diary may be relevant, it is not the priority action in this scenario.

C. Place the patient on bed rest: Placing the patient on bed rest is not indicated solely based on complaints of muscle cramps. Muscle cramps can have various causes, and restricting the patient's activity may not address the underlying issue. Additionally, bed rest could lead to other complications such as deconditioning or venous thromboembolism, which are not warranted in this situation.

D. Observing vital signs: While monitoring vital signs is a routine nursing intervention, it may not directly address the patient's complaint of muscle cramps. Vital signs may be relevant in assessing overall health status, but they may not provide specific information about the cause of muscle cramps or guide appropriate interventions.

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Correct Answer is C

Explanation

A. Perform doppler evaluation once daily: While Doppler evaluation is valuable for assessing blood flow and detecting vascular abnormalities, performing it only once daily may not provide adequate monitoring, especially during the critical early postoperative period. More frequent assessments are necessary to ensure optimal graft function and to promptly identify any complications.

B. Assess for compartment syndrome every 2 hours: While assessing for compartment syndrome is important, performing assessments every 2 hours may not be necessary unless specific risk factors or clinical indications are present. Continuous monitoring for signs and symptoms of compartment syndrome is essential, but the frequency of assessment should be based on the patient's condition and the surgeon's orders.

C. Assess pulse of affected extremity every 15 minutes until stable: After popliteal bypass graft surgery, assessing the pulse of the affected extremity every 15 minutes until stable is crucial. Frequent pulse checks help monitor graft patency and perfusion to detect early signs of graft failure or ischemia. This high-frequency assessment allows for prompt identification of vascular compromise and timely intervention to prevent graft thrombosis or occlusion. Once the pulse is stable and adequate perfusion is confirmed, the frequency of pulse checks can be adjusted according to the patient's condition and clinical guidelines.

D. Palpate the affected leg for pain every shift: Palpating the affected leg for pain every shift is an important component of postoperative assessment. However, relying solely on pain assessment once per shift may not provide timely detection of complications or changes in the patient's condition, especially during the immediate postoperative period when close monitoring is necessary. Frequent and ongoing assessment of pain, along with other vital signs and clinical indicators, is essential for comprehensive postoperative care.

A. Reluctance to monitor blood pressure at home B. Reduction in work hours C. Initiation of an exercise plan D. Preference for a low sodium diet

Correct Answer is A

Explanation

A. Reluctance to monitor blood pressure at home: One barrier to blood pressure management in patients newly diagnosed with hypertension is reluctance or resistance to monitor blood pressure at home. Home blood pressure monitoring is an essential component of hypertension management as it allows patients and healthcare providers to track blood pressure trends, assess the effectiveness of treatment, and make adjustments as needed. However, some patients may feel apprehensive about self-monitoring or may lack understanding of its importance, leading to reluctance to engage in this aspect of their care. Addressing this barrier requires patient education, encouragement, and support to promote the benefits of home blood pressure monitoring and empower patients to take an active role in managing their hypertension.

B. Reduction in work hours: While work-related stress and long working hours can contribute to hypertension, a reduction in work hours would not typically be considered a barrier to blood pressure management, especially if it allows for better stress management, lifestyle modifications, and adherence to treatment regimens.

C. Initiation of an exercise plan: Starting an exercise plan is generally considered a positive step in blood pressure management rather than a barrier. Regular physical activity helps lower blood pressure, improve cardiovascular health, and promote overall well-being. However, barriers related to exercise adherence, such as lack of time, motivation, or access to suitable facilities, could hinder effective blood pressure management.

D. Preference for a low sodium diet: Opting for a low sodium diet is beneficial for individuals with hypertension as it helps reduce blood pressure levels and lowers the risk of cardiovascular events. Therefore, a preference for a low sodium diet would not be considered a barrier to blood pressure management. However, barriers related to dietary adherence, such as taste preferences, cultural influences, or difficulty in meal planning, may need to be addressed to support long-term dietary changes and improve blood pressure control.

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A patient taking an angiotensin receptor blocker (AR) to control blood pressure is now complaining of muscle cramps which action will the nurse implement?

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