A 65-year-old male with coronary artery disease is prescribed Nitroglycerin. During discharge teaching, the nurse should emphasize that the patient must avoid taking phosphodiesterase type 5 (PDE-5) inhibitors, like Sildenafil (Viagra). What is the primary reason for this contraindication?
Increased risk of arrhythmias due to drug interactions.
Potential for life-threatening hypotension due to excessive vasodilation.
Increased risk of severe headache due to overlapping side effects.
Decreased effectiveness of nitroglycerin in relieving angina.
The Correct Answer is B
A. Increased risk of arrhythmias due to drug interactions: While both drugs affect cardiovascular function, the primary risk with concurrent use is not arrhythmias. Nitroglycerin and PDE-5 inhibitors mainly influence vascular tone, not cardiac electrical activity directly.
B. Potential for life-threatening hypotension due to excessive vasodilation: Both nitroglycerin and PDE-5 inhibitors are potent vasodilators. When used together, they can cause profound hypotension due to synergistic effects on the vascular system, which may lead to syncope, myocardial infarction, or even death.
C. Increased risk of severe headache due to overlapping side effects: Headache is a known side effect of both drugs due to vasodilation, but it is not the most dangerous interaction. While uncomfortable, headaches are not life-threatening compared to the risk of severe hypotension.
D. Decreased effectiveness of nitroglycerin in relieving angina: There is no evidence that PDE-5 inhibitors reduce the efficacy of nitroglycerin. The concern is not about reduced therapeutic benefit but rather the risk of severe, potentially fatal cardiovascular side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["42"]
Explanation
Total volume to be infused = 250 mL
Total infusion time = 90 minutes
Drop factor = 15 gtt/mL
- Calculate the flow rate in drops per minute (gtt/min):
Flow rate (gtt/min) = (Total volume (mL) × Drop factor (gtt/mL)) / Total infusion time (minutes)
= (250 mL × 15 gtt/mL) / 90 minutes
= 3750 gtt / 90 minutes
= 41.666... gtt/min
- Round to the nearest whole number:
Rounded flow rate = 42 gtt/min
Correct Answer is A
Explanation
A. Avoid caffeine while taking this medication: Theophylline is a methylxanthine, similar in structure and effect to caffeine. Concurrent use can increase CNS stimulation and risk of side effects such as insomnia, tachycardia, and tremors. Avoiding caffeine helps prevent toxicity and unwanted stimulation.
B. Crush your extended-release tablet and mix it with apple sauce for easier consumption: Extended-release formulations should never be crushed, as this can lead to rapid absorption and potentially toxic drug levels. Theophylline has a narrow therapeutic index, and proper dosing is critical.
C. Take this medication as needed when you are not feeling well: Theophylline is a maintenance medication meant to be taken on a regular schedule. Taking it only as needed undermines its therapeutic effectiveness and can lead to inconsistent symptom control.
D. Consume a high-protein diet: While diet can influence drug metabolism, there is no routine recommendation for a high-protein diet with Theophylline. In fact, sudden dietary changes can alter its metabolism, requiring careful monitoring of serum drug levels.
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