A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following Instructions should the nurse include?

"Reduce intake of potassium-rich foods."

"Take this medication before bedtime."

"Avoid grape juice.'

"Monitor for leg cramps."

Answer and Explanation

The Correct Answer is D

A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.

B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.

C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.

D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."

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Correct Answer is C

Explanation

A) Routinely exercise indoors:
Exercising indoors may be beneficial for individuals taking anticholinergic drugs to minimize the risk of heat-related complications. However, this option does not directly address the need to avoid extremes of temperature on exertion, which is crucial for preventing heat exhaustion and heat stroke. While indoor exercise can provide a controlled environment, it does not eliminate the risk entirely, especially if the indoor area is not adequately ventilated or air-conditioned.

B) Wear dark, warm clothing during the summer months:
Wearing dark, warm clothing during the summer months can exacerbate the risk of heat-related complications for individuals taking anticholinergic drugs. Dark clothing absorbs more heat from the sun, increasing body temperature, and warm clothing further contributes to heat retention. This option does not align with the goal of minimizing the risk of heat exhaustion and heat stroke.

C) Avoid extremes of temperature on exertion:
This is the correct answer. Avoiding extremes of temperature on exertion is essential for individuals taking anticholinergic drugs to reduce the risk of heat-related complications such as heat exhaustion and heat stroke. Exertion in hot environments can lead to excessive sweating and dehydration, further compromising thermoregulation. By avoiding extremes of temperature and moderating exertion, individuals can better regulate body temperature and minimize the risk of heat-related adverse effects.

D) Take frequent showers in the evenings and early mornings:
While taking frequent showers in the evenings and early mornings may help cool the body and reduce the risk of heat-related discomfort, it does not specifically address the need to avoid extremes of temperature on exertion. While personal hygiene practices are important, they should be supplemented with measures aimed at preventing heat-related complications, such as avoiding exertion in extreme temperatures. Therefore, this option does not fully meet the goal of minimizing the risk of heat exhaustion and heat stroke for individuals taking anticholinergic drugs.

A. Obstructive sleep apnea (OSA) B. A diet high in potassium C. High-density lipoprotein (HDL) level of 70 mg/dL D. Taking benazepril E. Cigarette smoking

Correct Answer is ["A","E"]

Explanation

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.

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A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following Instructions should the nurse include?

Nursing Test Bank

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Correct Answer is C

Explanation

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