What assessment should the nurse make before administering beta-adrenergic blocking agents?

A) Excretion:
This is the correct answer. The kidneys play a crucial role in the excretion of drugs and their metabolites from the body. After drugs undergo metabolism in the liver or other tissues, the resulting metabolites are often water-soluble and can be filtered by the kidneys into the urine. This process helps eliminate drugs and their byproducts from the body, preventing their accumulation and potential toxicity.

B) Absorption:
Absorption refers to the movement of drugs from the site of administration into the bloodstream. While the kidneys do not directly facilitate drug absorption, they may indirectly influence drug absorption by regulating blood flow and systemic circulation.

C) Metabolism:
Metabolism, or biotransformation, involves the enzymatic alteration of drugs into metabolites, which are often more water-soluble and easier to excrete. While the liver is the primary site of drug metabolism, the kidneys do not play a direct role in drug metabolism.

D) Distribution:
Distribution refers to the movement of drugs from the bloodstream to various tissues and organs in the body. While the kidneys do not directly influence drug distribution, changes in renal function can affect drug distribution by altering blood flow and plasma protein binding. However, the primary role of the kidneys in pharmacokinetics is excretion, not distribution.

A) Obstructive sleep apnea (OSA):
Obstructive sleep apnea is a known risk factor for the development of hypertension. During episodes of sleep apnea, breathing repeatedly stops and starts, leading to disruptions in normal sleep patterns and potentially contributing to increased sympathetic nervous system activity, systemic inflammation, and endothelial dysfunction, all of which can elevate blood pressure over time.

B) The choice B was incorrect. While a diet high in potassium is generally associated with lower blood pressure due to its beneficial effects on blood vessel function and fluid balance, it is not considered a risk factor for developing hypertension. In fact, potassium-rich foods like fruits, vegetables, and legumes are often recommended as part of a heart-healthy diet to help manage blood pressure.

C) The choice C was incorrect. A high-density lipoprotein (HDL) level of 70 mg/dL is actually considered beneficial for cardiovascular health. HDL is often referred to as "good" cholesterol because it helps remove LDL (low-density lipoprotein) cholesterol from the bloodstream, reducing the risk of plaque buildup in the arteries. Having a high HDL level is typically associated with a lower risk of cardiovascular disease, including hypertension.

D) The choice D was incorrect. Benazepril is actually an antihypertensive medication, specifically an angiotensin-converting enzyme (ACE) inhibitor. It is used to treat hypertension, not as a risk factor for its development. ACE inhibitors work by relaxing blood vessels, which helps lower blood pressure. While taking certain medications like benazepril may contribute to the management of hypertension, they are not considered risk factors for its development.

E) Cigarette smoking:
Cigarette smoking is a well-established risk factor for the development of hypertension. Smoking cigarettes can lead to the constriction of blood vessels, increased heart rate, and damage to the lining of blood vessels, all of which can elevate blood pressure. Additionally, the chemicals in tobacco smoke can contribute to inflammation and oxidative stress, further exacerbating cardiovascular risk factors. Smoking cessation is an essential component of hypertension management and overall cardiovascular health.