The nurse is caring for a client with heart failure who is being discharged on lisinopril 10 mg PO bid. Which teaching about this medication should be included in the discharge instructions?
Have blood drawn weekly to check for high magnesium levels
Avoid the use of salt substitutes in your diet
Notify your physician if a headache develops
Take your heart rate daily when on this medication
The Correct Answer is B
A. Have blood drawn weekly to check for high magnesium levels: Lisinopril, an ACE inhibitor, does not significantly affect magnesium levels. Regular monitoring is more important for potassium and renal function (BUN/creatinine), especially in heart failure patients, not magnesium.
B. Avoid the use of salt substitutes in your diet: Lisinopril is an ACE inhibitor. ACE inhibitors can cause potassium retention by reducing the production of aldosterone. Many salt substitutes contain high amounts of potassium chloride and combining the two may lead to hyperkalemia. Patients should be instructed to avoid these substitutes unless approved by their provider.
C. Notify your physician if a headache develops: Headache is a relatively common and usually mild side effect of lisinopril. It does not typically warrant discontinuation or immediate provider notification unless it's severe or persistent with other symptoms like dizziness or visual changes.
D. Take your heart rate daily when on this medication: Lisinopril does not significantly affect heart rate. Monitoring blood pressure is more relevant, as ACE inhibitors are antihypertensives. Heart rate monitoring is more critical with beta blockers or calcium channel blockers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The TEE evaluates if emboli are present if cardioversion is required: A transesophageal echocardiogram (TEE) provides detailed imaging of the heart’s chambers, particularly the left atrium and left atrial appendage, where clots often form in atrial fibrillation. It is used to rule out thrombi before cardioversion to reduce the risk of stroke during the procedure.
B. The study will use electric current to stop the abnormal conduction pathway: This describes electrical cardioversion, not TEE. TEE is a diagnostic imaging procedure and does not involve the delivery of electrical currents to modify the heart's rhythm or conduction.
C. A TEE will help restore the client's underlying baseline normal rhythm: TEE does not treat arrhythmias. Its role is diagnostic—to visualize cardiac structures, not to restore normal rhythm. Cardioversion or pharmacologic agents are required to correct atrial fibrillation.
D. A TEE is required prior to implantable defibrillator placement in clients with atrial fibrillation: TEE is not routinely required before implantable cardioverter-defibrillator (ICD) placement. ICD decisions are usually based on ejection fraction, rhythm stability, and risk of sudden cardiac arrest, not the presence or absence of atrial thrombi.
Correct Answer is ["35"]
Explanation
Calculate the total infusion time in minutes.
Infusion time in minutes = 2 hours × 60 minutes/hour
= 120 minutes
Calculate the total number of drops to be infused.
The total volume remaining is 350 mL
Drip factor is 12 gtts/mL.
Total drops = Total volume (mL) × Drop factor (gtts/mL)
Total drops = 350 mL × 12 gtts/mL
= 4200 gtts
Calculate the IV flow rate in drops per minute (gtts/min).
IV rate (gtts/min) = Total drops / Total infusion time (minutes)
= 4200 gtts / 120 minutes
= 35
=35 gtts/min
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