The nurse is assessing a patient who is receiving metoprolol 2 days after an acute coronary syndrome (ACS), Which physiological action of metoprolol supports the desired or therapeutic response?
Increases contractility.
Increases preload.
Decreases afterload.
Decreases diastolic filing time.
The Correct Answer is C
A) Increases contractility: Metoprolol, a beta-blocker, actually decreases contractility. It reduces the force of contraction of the heart muscle, which can help reduce myocardial oxygen demand and improve outcomes after ACS. Increasing contractility would counteract the therapeutic goals of metoprolol in managing ACS.
B) Increases preload: Preload refers to the volume of blood in the ventricles at the end of diastole. Metoprolol does not increase preload; rather, it reduces myocardial workload and oxygen demand, which does not directly affect preload but rather the heart's performance overall.
C) Decreases afterload: Metoprolol reduces afterload indirectly by lowering blood pressure and decreasing heart rate, which helps reduce the workload on the heart. This reduction in afterload supports the therapeutic goals of metoprolol in managing ACS by decreasing the heart's work and improving cardiac efficiency.
D) Decreases diastolic filling time: Metoprolol slows the heart rate, which can lead to increased diastolic filling time, not a decrease. Increased filling time can be beneficial as it allows the heart more time to fill with blood between beats, thereby improving cardiac output.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hypokalemia: Hydrochlorothiazide is a thiazide diuretic that can cause potassium loss through increased urine production. A common side effect of thiazide diuretics is hypokalemia, which can lead to symptoms such as palpitations or the sensation of the heart skipping beats. Therefore, it is crucial to check the client’s potassium levels to determine if hypokalemia is contributing to the client's symptoms.
B. Hyponatremia: While thiazide diuretics can affect sodium levels, hypokalemia is more directly associated with the symptoms described. Hyponatremia (low sodium levels) might also occur but is less commonly linked to the symptom of a skipped heartbeat compared to hypokalemia.
C. Hyperphosphatemia: Hydrochlorothiazide is not known to cause significant changes in phosphate levels, and hyperphosphatemia is not typically associated with the sensation of skipped heartbeats.
D. Hypermagnesemia: This condition, which involves elevated magnesium levels, is not a common side effect of hydrochlorothiazide. Hypokalemia is a more relevant concern for the symptoms described.
Correct Answer is C
Explanation
A. Withhold the medication until the client’s breakfast tray is available on the unit: Withholding the medication until food is available is not necessary, as risedronate should be taken on an empty stomach to ensure proper absorption. Food can interfere with the medication's effectiveness.
B. Consult with a pharmacist about scheduling the dose one hour after the client eats: This option is not suitable as risedronate should be taken on an empty stomach, and delaying the dose until after eating would compromise the medication's effectiveness.
C. Instruct the client that it is necessary to take nothing but water with the medication: Risedronate must be taken on an empty stomach with a full glass of water and the client should remain upright for at least 30 minutes afterward. Milk or other beverages can interfere with the absorption of risedronate.
D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk: This is not appropriate, as risedronate should be taken with water only to ensure proper absorption. Milk can reduce the effectiveness of the medication.
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