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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: This is not an appropriate instruction for the nurse to include in the client's plan of care. Replacing salt with a salt substitute is not recommended for clients taking spironolactone, as most salt substitutes contain potassium. Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia, or high levels of potassium in the blood. The client should avoid salt substitutes and other sources of potassium.

Choice B reason: This is not an appropriate instruction for the nurse to include in the client's plan of care. Monitoring skin for excessive bruising is not related to the use of spironolactone, as it does not affect the blood clotting process. The client should monitor for signs of bleeding, such as nosebleeds, gum bleeding, or blood in the urine or stool, if he or she is taking other medications that can interfere with clotting, such as aspirin or warfarin.

Choice C reason: This is not an appropriate instruction for the nurse to include in the client's plan of care. Covering the skin before going outside is not necessary for clients taking spironolactone, as it does not cause photosensitivity or increased risk of sunburn. The client should protect the skin from sun exposure as part of general health promotion, but it is not specific to spironolactone therapy.

Choice D reason: This is the appropriate instruction for the nurse to include in the client's plan of care. Limiting intake of high-potassium foods is important for clients taking spironolactone, as it can prevent hyperkalemia and its complications, such as cardiac arrhythmias, muscle weakness, or paralysis. The client should avoid foods that are rich in potassium, such as bananas, oranges, tomatoes, potatoes, spinach, and dairy products. The client should also have regular blood tests to monitor the potassium levels.

A. Lorazepam. B. Digoxin. C. Sucralfate. D. Vancomycin.

Correct Answer is D

Explanation

Choice A reason: Lorazepam is a benzodiazepine that is used to treat anxiety, insomnia, and seizures. It is metabolized by the liver and does not have a significant effect on the kidneys. The nurse should monitor the client for signs of sedation, respiratory depression, and dependence.

Choice B reason: Digoxin is a cardiac glycoside that is used to treat heart failure and arrhythmias. It is eliminated by the kidneys and can cause toxicity if the renal function is impaired. The nurse should monitor the client's serum digoxin level, heart rate, and rhythm, and signs of toxicity, such as nausea, vomiting, visual disturbances, and confusion.

Choice C reason: Sucralfate is a mucosal protectant that is used to treat peptic ulcer disease. It forms a protective barrier over the ulcer and does not get absorbed into the bloodstream. It does not affect the kidneys and has few side effects. The nurse should monitor the client's symptoms and advise them to take the medication on an empty stomach.

Choice D reason: Vancomycin is an antibiotic that is used to treat serious infections caused by gram-positive bacteria. It is nephrotoxic and can cause AKI, especially in high doses or prolonged use. The nurse should monitor the client's serum vancomycin level, renal function tests, urine output, and signs of AKI, such as oliguria, edema, and electrolyte imbalances.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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