The nurse administers losartan 50 mg PO to a client. One hour after administration, the client calls the nurse and complains of tingling of the lips. The nurse notes that the client's lips are edematous and recognizes that the client is experiencing anaphylaxis and notifies the healthcare provider. The client requires supplemental oxygen and a fluid bolus. Which statement is true regarding this situation?
The client had an allergic reaction to losartan.
The client had an expected side effect of the medication.
The client should have a prescription change to enalapril.
The client should avoid taking the medication with food.
The Correct Answer is A
Choice A reason: The client had an allergic reaction to losartan, a drug that belongs to the class of angiotensin II receptor blockers (ARBs). ¹ Anaphylaxis is a severe and potentially life-threatening allergic reaction that can cause swelling of the lips, tongue, throat, and face, as well as difficulty breathing, low blood pressure, and shock. ² The client needs immediate medical attention and treatment with oxygen, fluids, and epinephrine. ³
Choice B reason: The client did not have an expected side effect of the medication. Losartan is used to treat high blood pressure and heart failure by blocking the action of angiotensin II, a hormone that causes blood vessels to constrict and retain salt and water. ¹ Some common side effects of losartan include dizziness, headache, fatigue, cough, and nausea. ⁴ Anaphylaxis is not a common or expected side effect of losartan, but a rare and serious adverse reaction.
Choice C reason: The client should not have a prescription change to enalapril. Enalapril is another drug that lowers blood pressure and heart failure, but it belongs to the class of angiotensin-converting enzyme (ACE) inhibitors. ⁵ ACE inhibitors and ARBs have similar mechanisms of action and effects, but they differ in how they block the angiotensin system. However, both classes of drugs can cause allergic reactions and anaphylaxis in some people, especially those who have a history of allergy to either drug. The client should avoid both ACE inhibitors and ARBs and use another type of blood pressure medication.
Choice D reason: The client should not avoid taking the medication with food. Food does not affect the absorption or effectiveness of losartan. ⁴ The client can take the medication with or without food, as directed by the provider. However, the client should avoid grapefruit and grapefruit juice, as they can interact with losartan and increase the risk of side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
Choice A: Elevated troponins. This is a correct answer. Troponins are proteins that regulate the myocardial contractile process². They are released into the bloodstream when the myocardial cells are damaged by ischemia or infarction². Troponins are highly specific and sensitive indicators of myocardial injury². The normal range for troponin I is less than 0.03 ng/mL and for troponin T is less than 0.01 ng/mL².
Choice B: Decreased homocysteine levels. This is not a correct answer. Homocysteine is an amino acid that is involved in the metabolism of methionine². Elevated homocysteine levels are associated with an increased risk of cardiovascular disease, but they are not a direct marker of myocardial injury². The normal range for homocysteine is 5 to 15 micromol/L².
Choice C: Elevated CK-MB. This is a correct answer. CK-MB is one of the isoenzymes of creatine kinase, an enzyme that catalyzes the conversion of creatine to phosphocreatine, which is used for energy storage in the muscles². CK-MB is found mainly in the myocardium and is released into the blood when the myocardial cells are injured². CK-MB is a specific and sensitive marker of myocardial injury, but it is less specific than troponins². The normal range for CK-MB is 0 to 3 ng/mL².
Choice D: Decreased alkaline phosphatase (ALP).This is not a correct answer. ALP is an enzyme that is found in various tissues, such as the liver, bone, intestine, and placenta². ALP is not a marker of myocardial injury, and its levels are not affected by ischemia or infarction². The normal range for ALP is 30 to 120 U/L².
Choice E: Increased platelet count.This is not a correct answer. Platelets are blood cells that are involved in hemostasis and clot formation². Increased platelet count, or thrombocytosis, can be a sign of inflammation, infection, malignancy, or other conditions². Platelet count is not a marker of myocardial injury, and it does not reflect the extent of ischemia or infarction². The normal range for platelet count is 150,000 to 450,000 per microliter of blood².
Correct Answer is A
Explanation
Choice A reason: This is the most concerning result for the nurse. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in the urine. A high creatinine level indicates impaired kidney function, which can be a complication of hypertension. The normal range of creatinine is 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women. A creatinine level of 3.2 mg/dL is more than twice the upper limit of normal and suggests severe kidney damage.
Choice B reason: This is not a concerning result for the nurse. Potassium is an electrolyte that is essential for the function of nerves and muscles, especially the heart. The normal range of potassium is 3.5 to 5.0 mEq/L. A potassium level of 3.4 mEq/L is slightly below the normal range, but not enough to cause serious problems. A low potassium level can be caused by diuretics, vomiting, diarrhea, or excessive sweating. The nurse should monitor the client's potassium level and symptoms, and advise the client to eat foods that are high in potassium, such as bananas, oranges, potatoes, and tomatoes.
Choice C reason: This is not a concerning result for the nurse. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues. The normal range of hemoglobin is 13.5 to 17.5 g/dL for men and 12.0 to 15.5 g/dL for women. A hemoglobin level of 12.8 g/dL is within the normal range for women and slightly below the normal range for men, but not enough to cause significant anemia. A low hemoglobin level can be caused by blood loss, iron deficiency, or bone marrow disorders. The nurse should assess the client's history, diet, and symptoms, and check for other signs of anemia, such as pallor, fatigue, and shortness of breath.
Choice D reason: This is not a concerning result for the nurse. Blood urea nitrogen (BUN) is a waste product of protein metabolism that is filtered by the kidneys and excreted in the urine. A high BUN level indicates impaired kidney function or dehydration. The normal range of BUN is 7 to 20 mg/dL. A BUN level of 20 mg/dL is at the upper limit of normal, but not enough to indicate serious kidney problems. The nurse should ensure that the client is well hydrated and monitor the client's urine output and specific gravity.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today