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. "The medication can take up to 15 minutes to take effect." - This statement is not accurate, sublingual nitroglycerin works rapidly and often provides relief within a few minutes.
B. Sublingual nitroglycerin is administered by placing the tablet under the tongue, and it should be allowed to dissolve or be absorbed directly into the bloodstream through the mucous membranes. It is not swallowed or chewed. The small sip of water can help facilitate the dissolving process.
C. "Avoid taking the medication prior to exercising." - This statement is not accurate. Nitroglycerin can be taken before anticipated exertion or activities that may trigger angina to prevent anginal episodes during physical activity.
D. "Stop taking the medication and notify your provider if you develop a headache." - While headaches are a common side effect of nitroglycerin, they are generally transient and not a reason to stop taking the medication. Persistent or severe headaches should be reported to the healthcare provider.
Correct Answer is ["A","C","D"]
Explanation
A. Apply pressure to the nares:
Applying gentle pressure to the nares can help control bleeding.
B. Tilt the client's head backward:
Tilt the head forward slightly to prevent blood from flowing down the back of the throat and to avoid swallowing blood.
C. Place ice to the bridge of the client's nose:
Cold packs can help constrict blood vessels and reduce bleeding.
D. Move the client into high-Fowler's position:
Sitting the client upright in a high-Fowler's position can minimize blood flow to the head and reduce bleeding.
E. Instruct the client to blow his nose:
Blowing the nose may disrupt clots and increase bleeding.
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