An older adult client is being discharged after a myocardial infarction (MI) and receives a new prescription for atenolol. Which instruction is most important for the nurse to include in this client's teaching plan?
Avoid driving or operating machinery.
Take a missed dose as soon as possible.
Standing slowly when getting up from bed.
Avoid intake of alcoholic beverages.
The Correct Answer is C
A. Avoid driving or operating machinery: Drowsiness and dizziness can occur with atenolol, especially when initiating therapy, but these effects are usually mild. While it's reasonable to use caution initially, this is not the most critical teaching point compared to orthostatic safety.
B. Take a missed dose as soon as possible: Although this may seem helpful, patients should not double doses or take extra doses close together. If a significant amount of time has passed, the missed dose may need to be skipped to prevent bradycardia or hypotension.
C. Standing slowly when getting up from bed: Atenolol, a beta-blocker, can cause orthostatic hypotension, especially in older adults. Teaching the client to rise slowly helps reduce the risk of dizziness and falls, making this a high-priority safety instruction following discharge.
D. Avoid intake of alcoholic beverages: Alcohol may enhance the hypotensive effects of beta-blockers, but moderate consumption is not strictly contraindicated. This advice is relevant but less urgent than preventing injury from orthostatic hypotension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Serum liver enzymes: Statins are metabolized in the liver and can cause hepatotoxicity. Baseline liver enzyme levels, such as ALT and AST, should be reviewed before starting statin therapy to ensure the liver is functioning properly and to monitor for potential adverse effects.
B. Serum electrolytes: Electrolytes are important for overall health, but they are not specifically impacted by statin therapy. Reviewing electrolyte levels is not a priority before initiating statins unless other conditions warrant it.
C. Complete blood count: A complete blood count (CBC) provides valuable information about infection or anemia, but it is not directly related to the safety or monitoring of statin medications.
D. Capillary blood glucose: Statins have been associated with a slight risk of elevated blood glucose over long-term use, but an initial capillary blood glucose reading is not required prior to starting therapy. Liver function assessment is the priority.
Correct Answer is C
Explanation
A. Compress the client's nares: Compressing the nares is a technique used for nasal medication administration or controlling nosebleeds, not for sublingual or oral spray forms of nitroglycerin. This action is unrelated to nitroglycerin use for angina.
B. Observe for facial flushing: Facial flushing is a common side effect of nitroglycerin due to vasodilation. While it should be noted during monitoring, it is not the immediate next action after administration when addressing angina symptoms.
C. Advise the client to rest: Resting after nitroglycerin administration reduces myocardial oxygen demand, helping to relieve anginal pain more effectively. It also helps prevent hypotension and dizziness, which are common side effects of the medication.
D. Elevate the client's feet: Elevating the feet is typically done if hypotension occurs. It is not a standard next step immediately after giving nitroglycerin unless the client shows symptoms like syncope or significant blood pressure drops.
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