The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications?
Carvedilol
Captopril
Isosorbide dinitrate
Fluticasone
The Correct Answer is A
A. Carvedilol: Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.
B. Captopril: Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.
C. Isosorbide dinitrate: Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.
D. Fluticasone: Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Foot ulcers: Foot ulcers are more commonly associated with the later stages of peripheral arterial disease (PAD) when there is significant impairment of blood flow to the extremities, leading to tissue damage and delayed wound healing.
B. Intermittent claudication: This is the correct answer. Intermittent claudication is a classic symptom of PAD in the early stage. It is characterized by cramping leg pain or discomfort that occurs during physical activity, such as walking, and is relieved by rest. It is caused by insufficient blood flow to meet the demands of the muscles during exercise.
C. Rest pain: Rest pain is typically a symptom of more advanced PAD. It occurs when blood flow is severely compromised even at rest, leading to pain in the affected extremity that is not relieved by activity.
D. Dependent rubor: Dependent rubor is a sign of severe PAD and occurs when the foot or leg becomes red or flushed when in a dependent position. It is associated with compromised arterial blood flow.
Correct Answer is D
Explanation
Correct answer: D
A.Elevate the head of the bed 45":Do not elevate the head of the bed more than 15 degrees.Elevating the head of the bed can increase the risk of bleeding from the insertion site.
B.Keep the affected leg slightly flexed: The affected leg should be kept straight to prevent movement at the insertion site, which can cause bleeding
C. Keep the client NPO for 4 hr: There is typically no need to keep the client NPO for an extended period after a cardiac catheterization. However, individual protocols may vary, and the nurse should follow the specific instructions provided by the healthcare provider.
D.Have the client lie flat in bed: After a cardiac catheterization, it is important to keep the client lying flat to prevent bleeding or hematoma formation at the catheter insertion site. This position helps to maintain pressure on the insertion site, particularly if the catheter was inserted through the femoral artery.
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