A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?

Rationale:

A. Orthopnea, difficulty breathing while lying flat, is a common finding in individuals with heart failure as it helps to relieve pressure on the diaphragm and lungs.

B. Weight loss is less likely in heart failure and may indicate other issues such as malnutrition or metabolic disturbances.

C. Increased urine output is not typically associated with heart failure but rather with conditions such as diabetes insipidus or kidney disease.

D. Bradycardia, a slow heart rate, is not typically associated with heart failure, which often presents with tachycardia as the body compensates for decreased cardiac output.

Rationale:

A. Metronidazole: Metronidazole is an antibiotic and does not have significant interactions with sildenafil.

B. Phenytoin: Phenytoin is an anticonvulsant medication and does not have significant interactions with sildenafil.

C. Prednisone: Prednisone is a corticosteroid and does not have significant interactions with sildenafil.

D. Isosorbide: Isosorbide is a nitrate medication used to treat angin

A. Combining sildenafil with nitrate medications can lead to severe hypotension and is contraindicated. Sildenafil potentiates the vasodilatory effects of nitrates, which can result in a dangerous drop in blood pressure.