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."
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."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Respiratory rate 18/min:
A respiratory rate of 18/min is within the normal range for adults and is not a contraindication for administering atenolol. This finding does not warrant withholding the medication.
B) Oxygen saturation 95%:
An oxygen saturation of 95% is within the normal range and does not indicate any acute respiratory compromise. It is not a contraindication for administering atenolol.
C) Heart rate 46/min:
A heart rate of 46/min is below the normal range (typically 60-100 beats per minute for adults). Atenolol is a beta-blocker that primarily acts to reduce heart rate and blood pressure. Administering atenolol to a client with bradycardia (heart rate less than 60/min) can further decrease heart rate and may lead to symptomatic bradycardia or heart block. Therefore, the nurse should withhold atenolol in this case and notify the healthcare provider.
D) Blood pressure 160/94 mm Hg:
A blood pressure of 160/94 mm Hg indicates hypertension (elevated blood pressure). While atenolol is often prescribed for the management of hypertension, this blood pressure reading alone does not warrant withholding the medication. However, the client's bradycardia (heart rate 46/min)’is a more immediate concern that requires action."
Correct Answer is ["B","C","E"]
Explanation
A) Hypoglycemia:
Propranolol, a nonselective beta-blocking agent, can mask some of the symptoms of hypoglycemia, such as tachycardia and tremors, by blocking the sympathetic response. Therefore, it is not typically used in the treatment of hypoglycemia and may even exacerbate low blood sugar levels.
B) Arrhythmias:
Propranolol is commonly used in the treatment of various cardiac arrhythmias. By blocking beta-adrenergic receptors in the heart, it reduces the heart rate and myocardial contractility, thereby helping to control arrhythmias such as atrial fibrillation and ventricular tachycardia.
C) Hypertension:
Propranolol is effective in lowering blood pressure and is often prescribed for the management of hypertension. Its beta-blocking action reduces cardiac output and suppresses renin release, leading to decreased systemic vascular resistance and blood pressure.
D) Hypokalemia:
Propranolol does not have a direct role in the treatment of hypokalemia. While it can potentially exacerbate hypokalemia through its effects on potassium metabolism, it is not a primary treatment for this electrolyte imbalance.
E) Angina:
Propranolol is indicated for the treatment of angina pectoris, particularly in cases of stable angina. By reducing myocardial oxygen demand through its negative chronotropic and inotropic effects, it helps relieve anginal symptoms and improve exercise tolerance."
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