A client presents to the healthcare setting and ordered verapamil to treat his hypertension. Which assessment finding by the nurse would determine if the medication should be held?
Pulse oximetry of 92%
Pulse of 78
Respiratory rate of 12
History of a myocardial infarction a week ago
The Correct Answer is D
A) Pulse oximetry of 92%: While a pulse oximetry reading of 92% is slightly below normal, it is not a definitive reason to hold verapamil. This reading indicates mild hypoxemia, but it does not directly contraindicate the use of verapamil. Other factors should be considered before making a decision based solely on this value.
B) Pulse of 78: A pulse rate of 78 beats per minute is within the normal range for adults and does not warrant holding verapamil. This finding alone does not indicate any immediate concerns related to the administration of the medication.
C) Respiratory rate of 12: A respiratory rate of 12 breaths per minute is within the normal range for adults. This finding does not provide any indication that verapamil should be withheld. It is important to consider other clinical factors when assessing the appropriateness of medication administration.
D) History of myocardial infarction a week ago: Verapamil, a calcium channel blocker, can have significant effects on cardiac function. Administering it to a client who recently experienced a myocardial infarction (heart attack) could exacerbate cardiac issues and lead to complications. Therefore, it is crucial to hold the medication and consult with the healthcare provider before proceeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Hypokalemia: Hypokalemia, or low potassium levels, significantly increases the risk of digoxin toxicity. Since digoxin competes with potassium for binding at the sodium-potassium ATPase site in the heart, low potassium levels can lead to increased digoxin effects and toxicity. Therefore, it is crucial to monitor potassium levels and correct any deficiencies before administering digoxin.
B) Hyperkalemia: While hyperkalemia is a serious concern and can also affect digoxin therapy, it usually results in decreased effectiveness of digoxin rather than increasing toxicity. Elevated potassium levels can diminish the drug's positive inotropic effect.
C) Hypocalcemia: Although calcium levels can influence cardiac function, hypocalcemia is not directly related to digoxin toxicity. Monitoring calcium is important for overall cardiac health, but it is not the primary focus when assessing the risk for digoxin toxicity.
D) Hypernatremia: Elevated sodium levels do not have a direct impact on the efficacy or toxicity of digoxin. While sodium levels are essential to monitor for overall health, they are not critical in the context of digoxin administration and toxicity risk.
Correct Answer is B
Explanation
A) Carvedilol: While carvedilol is a beta-blocker that can be used to treat hypertension, it is not considered a first-line treatment. Beta-blockers are typically used when other first-line agents are not effective or in specific situations such as heart failure or ischemic heart disease.
B) Lisinopril: Lisinopril is an ACE inhibitor and is considered a first-line treatment for hypertension. It effectively reduces blood pressure by inhibiting the angiotensin-converting enzyme, leading to vasodilation and decreased blood volume. Its well-documented efficacy and favorable side effect profile make it a common choice for initial therapy.
C) Clonidine: Clonidine is an alpha-2 adrenergic agonist that can lower blood pressure but is generally not used as a first-line treatment due to its side effects and potential for rebound hypertension if discontinued abruptly.
D) Doxazosin: Doxazosin is an alpha-1 blocker that can be used to treat hypertension but is not typically a first-line choice. It may be used in specific cases, such as in patients with benign prostatic hyperplasia, but other classes of medications are usually preferred for initial hypertension treatment.
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