A client who receives multiple antihypertensive medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse's decision to hold the client's scheduled antihypertensive medications?
Increased urinary clearance of the multiple medications has produced diuresis and lowered the blood pressure.
The synergistic effect of the multiple medications has resulted in drug toxicity and hypotension.
The antagonistic interaction among the various blood pressure medications has reduced their effectiveness.
The additive effect of multiple medications has caused the blood pressure to drop too low.
The Correct Answer is D
Choice A reason: Increased urinary clearance of the multiple medications is not the cause of the client's syncope. Diuresis is a common side effect of some antihypertensive medications, such as diuretics, but it does not lower the blood pressure to a dangerous level. The nurse should monitor the client's fluid and electrolyte balance and urine output, but it is not the priority action in this situation.
Choice B reason: The synergistic effect of the multiple medications is not the cause of the client's syncope. Synergism is when two or more drugs work together to produce a greater effect than the sum of their individual effects. This can be beneficial or harmful, depending on the drugs and the doses. The nurse should check the client's medication history and avoid prescribing drugs that have a negative synergistic effect, but it is not the most likely explanation for the client's hypotension.
Choice C reason: The antagonistic interaction among the various blood pressure medications is not the cause of the client's syncope. Antagonism is when two or more drugs work against each other to reduce or cancel out their effects. This can decrease the effectiveness of the treatment and increase the risk of complications. The nurse should check the client's medication history and avoid prescribing drugs that have a negative antagonistic effect, but it is not the most likely explanation for the client's hypotension.
Choice D reason: The additive effect of multiple medications is the most likely cause of the client's syncope. Additivity is when two or more drugs have a similar effect and their combined effect is equal to the sum of their individual effects. This can lower the blood pressure too much and cause symptoms such as dizziness, fainting, and shock. The nurse should hold the client's scheduled antihypertensive medications and notify the healthcare provider. The nurse should also monitor the client's vital signs, level of consciousness, and perfusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Muscle tenderness is a sign of myopathy, a rare but serious adverse effect of atorvastatin and other statins. Myopathy is characterized by muscle weakness, pain, and elevated CK levels. CK is an enzyme that is released when muscle tissue is damaged. The nurse should monitor the client for muscle tenderness and report any changes to the prescriber.
Choice B reason: Nausea and vomiting are common side effects of atorvastatin, but they are not related to CK levels. The nurse should advise the client to take the medication with food and fluids to minimize gastrointestinal discomfort.
Choice C reason: Excessive bruising is not a typical side effect of atorvastatin, nor is it associated with CK levels. The nurse should assess the client for other possible causes of bleeding, such as coagulation disorders, trauma, or drug interactions.
Choice D reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to CK levels. The nurse should assess the client for other signs of fluid retention, such as weight gain, shortness of breath, or jugular venous distension. The nurse should also check the client's blood pressure and heart rate, as peripheral edema may indicate heart failure or hypertension.
Correct Answer is A
Explanation
Choice A reason: This is the highest priority action for the nurse to take. Codeine is an opioid analgesic that can cause drowsiness, dizziness, and impaired coordination. These effects can increase the risk of falls and injuries in the client, especially when ambulating to the bathroom. The nurse should instruct the client to request assistance when getting out of bed or walking, and provide adequate support and supervision.
Choice B reason: This is not the highest priority action for the nurse to take. Administering a stool softener/laxative at the same time as the analgesic is a preventive measure that can help reduce the risk of constipation, which is a common side effect of codeine. However, this action is not as urgent or important as ensuring the client's safety and preventing falls.
Choice C reason: This is not the highest priority action for the nurse to take. Advising the client that the medication should start to work in about 30 minutes is an informative and reassuring measure that can help the client cope with pain and anxiety. However, this action is not as urgent or important as ensuring the client's safety and preventing falls.
Choice D reason: This is not the highest priority action for the nurse to take. Telling the client to notify the nurse if the pain is not relieved is an evaluative and responsive measure that can help the nurse monitor the effectiveness of the analgesic and adjust the dosage or frequency as needed. However, this action is not as urgent or important as ensuring the client's safety and preventing falls.
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