A client is admitted for acute renal failure and the nurse is monitoring their response to medications. Which pharmacokinetic principle does the nurse understand will be affected in this patient?

Choice A reason: This statement is true. The nurse should instruct the client to avoid getting up without assistance, as hydralazine can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can lead to dizziness, fainting, or falls.

Choice B reason: This statement is false. The nurse does not need to monitor the heart rate with this medication, as hydralazine is not a cardiac drug. Hydralazine is a vasodilator that relaxes the blood vessels and lowers the blood pressure. However, the nurse should monitor the blood pressure and adjust the dose accordingly.

Choice C reason: This statement is false. The nurse does not need to alter the medication with birth control, as hydralazine does not have a significant interaction with hormonal contraceptives. However, the nurse should advise the client to inform the prescriber if they are pregnant or planning to conceive, as hydralazine may have some effects on the fetus.

Choice D reason: This statement is false. The nurse does not need to report a dry cough, as hydralazine does not cause this side effect. A dry cough is more common with angiotensin-converting enzyme (ACE) inhibitors, which are another class of antihypertensive drugs.

Choice A reason: This statement is false. The nurse does not need to assess the client's sulfa allergy prior to giving nifedipine, as nifedipine is not a sulfa drug. Sulfa drugs are a group of antibiotics that contain the sulfonamide group and can cause allergic reactions in some people. Nifedipine is a calcium channel blocker that does not contain sulfonamide.

Choice B reason: This statement is false. The nurse does not need to assess the client's hemoglobin prior to giving nifedipine, as nifedipine does not affect the hemoglobin level. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues. Nifedipine is a calcium channel blocker that relaxes the blood vessels and improves the blood flow to the heart.

Choice C reason: This statement is false. The nurse does not need to assess the client's PTT prior to giving nifedipine, as nifedipine does not affect the blood clotting time. PTT stands for partial thromboplastin time, which is a test that measures how long it takes for the blood to clot. Nifedipine is a calcium channel blocker that does not interfere with the coagulation cascade.

Choice D reason: This statement is true. The nurse should assess the client's blood pressure prior to giving nifedipine, as nifedipine is a medication that lowers the blood pressure. The nurse should check the blood pressure and compare it with the baseline and the target values. The nurse should hold the nifedipine and notify the prescriber if the blood pressure is too low or too high. The nurse should also monitor the client's blood pressure after giving the nifedipine and report any changes.