The nurse is about to administer the combination medication chlorthalidone and atenolol to a client diagnosed with chronic hypertension. Which interventions should the nurse include in the plan of care? (Select all that apply)

Administer if the blood pressure is 90/60 and monitor for side effects

Hold if the heart rate is less than 60 beats per minute

Teach to dangle feet before standing

Encourage to limit the intake of potassium-rich foods

Monitor fluid intake and output

Answer and Explanation

Correct Answer : B,C,E

Choice A reason: Chlorthalidone and atenolol are used to treat hypertension⁴⁵. However, administering the medication when the blood pressure is 90/60 might not be advisable. This is because atenolol, a beta-blocker, can further lower the heart rate and blood pressure¹¹⁷. Therefore, it's important to monitor the patient's blood pressure before administration¹.

Choice B reason: Atenolol can slow the heart rate¹¹⁷. If the heart rate is already less than 60 beats per minute, which is the lower limit of the normal range¹, the medication should be held and the healthcare provider should be notified⁵.

Choice C reason: One of the side effects of atenolol and chlorthalidone is dizziness or lightheadedness¹¹⁷. Teaching the patient to dangle their feet before standing can help prevent orthostatic hypotension, a form of low blood pressure that happens when you stand up from sitting or lying down¹¹.

Choice D reason: Chlorthalidone is a diuretic that can cause the body to lose potassium¹¹⁷. However, atenolol does not have this effect⁵. Therefore, it's not necessary to limit the intake of potassium-rich foods unless advised by a healthcare provider.

Choice E reason: Monitoring fluid intake and output is important when administering diuretics like chlorthalidone⁵. This can help ensure the patient is not becoming dehydrated and help monitor the medication's effectiveness¹¹.

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Correct Answer is B

Explanation

Choice A reason: It is not the best intervention to exclude the family from the exercise program. Family involvement can provide support, motivation, and accountability for the client. Family members can also participate in the exercise program and benefit from its positive effects on blood pressure and overall health.

Choice B reason: This is the best intervention to help the client maintain the exercise program. Adapting the program to the client's needs and abilities ensures that the exercise is appropriate, safe, and effective for the client. It also increases the client's confidence, satisfaction, and adherence to the program.

Choice C reason: Providing the client with specific details of how to perform the exercises is an important intervention, but not the best one. The client may still have difficulties or barriers to maintaining the exercise program, such as lack of time, resources, or motivation. The nurse should also assess the client's readiness, preferences, and goals for the exercise program.

Choice D reason: Reassuring the client that they will be able to do the exercise program is a supportive intervention, but not the best one. The client may not feel reassured if the exercise program is too challenging, unrealistic, or unappealing for them. The nurse should also monitor the client's progress, feedback, and outcomes of the exercise program.

A. Be aware that pregnancy with sickle cell disease increases the risk of crisis B. Avoid travel to cities where the oxygen level is lower C. Strenuous exercise prevents the development of sickle cell crisis D. Avoid flying on commercial airlines E. Avoid drinking water on hot days.

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Pregnancy can increase the frequency and severity of sickle cell crises⁵⁶. Regular prenatal care is especially important for women with sickle cell disease⁵⁶. Therefore, it's crucial for a young female adult with sickle cell anemia to be aware that pregnancy increases the risk of crisis.

Choice B reason: Low oxygen levels can trigger a sickle cell crisis³. Therefore, avoiding travel to cities where the oxygen level is lower can help prevent crises.

Choice C reason: While regular, moderate exercise can be beneficial, strenuous exercise can lead to dehydration and fatigue, which can trigger a sickle cell crisis⁹[^10^]¹¹. Therefore, the statement that strenuous exercise prevents the development of sickle cell crisis is not accurate.

Choice D reason: Commercial airlines have controlled cabin pressure and oxygen levels, so flying is generally safe for individuals with sickle cell disease¹²³. However, it's always best to discuss travel plans with a healthcare provider³. Therefore, avoiding flying on commercial airlines is not necessarily a requirement.

Choice E reason: Dehydration can increase the risk of a sickle cell crisis, so it's important to drink plenty of fluids, especially in hot weather³.

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The nurse is about to administer the combination medication chlorthalidone and atenolol to a client diagnosed with chronic hypertension. Which interventions should the nurse include in the plan of care? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

The nurse is working collaboratively with the physical therapist to develop an exercise program for a client recently diagnosed with hypertension. Which intervention would be best to assist the client in maintaining the exercise program?

Correct Answer is B

Explanation

The nurse should instruct a young female adult with sickle cell anemia to do which of the following? (Select all that apply)

Correct Answer is ["A","B","E"]

Explanation

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