A nurse is caring for a 62-year-old female client on a medical-surgical unit.
Complete the following sentence by using the lists of options.
The client is at risk for
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
The client is at risk for hypotension due to hydrochlorothiazide.
Rationale for correct answers: Hydrochlorothiazide is a thiazide diuretic that reduces blood volume by promoting renal excretion of sodium and water, which lowers blood pressure. This mechanism can lead to hypotension, especially in postoperative patients with fluid shifts or concurrent antihypertensive therapy. Normal blood pressure is approximately 120/80 mm Hg, and this client’s current blood pressure of 92/75 mm Hg indicates mild hypotension, likely related to the diuretic effect of hydrochlorothiazide.
Rationale for incorrect Response 1 options:
Hypoglycemia is a low blood glucose state (below 70 mg/dL) often caused by excess insulin or insufficient food intake, but hydrochlorothiazide typically does not cause hypoglycemia. Instead, it can sometimes increase glucose levels due to altered insulin sensitivity. Hyperkalemia (elevated potassium >5.0 mEq/L) is unlikely because thiazides promote potassium excretion, tending toward hypokalemia rather than hyperkalemia. Infection risk is unrelated to hydrochlorothiazide use and would be influenced more by surgery or immune status.
Rationale for incorrect Response 2 options:
Insulin glargine is a long-acting insulin primarily influencing blood glucose, not blood pressure. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can cause renal impairment and fluid retention but does not directly cause hypotension. Glucose level is a lab value, not a medication or intervention that causes hypotension.
Take home points:
- Hydrochlorothiazide can cause hypotension through volume depletion and natriuresis.
- Blood pressure monitoring is essential in postoperative patients on diuretics.
- Differentiate drug-induced hypotension from other causes such as bleeding or sepsis.
- Understand that thiazides can increase blood glucose and decrease potassium levels, influencing diabetic management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Pseudoephedrine is a sympathomimetic agent that primarily acts as a vasoconstrictor and bronchodilator. It does not directly affect kidney function to cause polyuria. In fact, due to its vasoconstrictive properties, it could theoretically decrease renal blood flow, although this is not a common or expected adverse effect leading to increased urine output.
Choice B rationale
Pseudoephedrine's primary mechanism of action involves stimulating alpha- and beta-adrenergic receptors. It does not have a known effect on appetite regulation; it is not typically associated with either increased or decreased appetite. Therefore, an increased appetite is not an expected adverse effect of this medication.
Choice C rationale
Pseudoephedrine is a sympathomimetic drug that stimulates adrenergic receptors, leading to effects similar to sympathetic nervous system activation. This stimulation typically results in tachycardia, not bradycardia. It increases heart rate and contractility, which can be problematic for individuals with pre-existing cardiovascular conditions.
Choice D rationale
As a sympathomimetic, pseudoephedrine causes vasoconstriction by stimulating alpha-1 adrenergic receptors in the arterioles. This widespread vasoconstriction leads to an increase in peripheral vascular resistance, which in turn can elevate blood pressure. Therefore, hypertension is a common and important adverse effect to monitor for, especially in individuals with pre-existing hypertension.
Correct Answer is D
Explanation
Choice A rationale
Restlessness, also known as akathisia, is not a typical expected adverse effect of ondansetron. Ondansetron primarily acts as a selective 5-HT3 receptor antagonist, blocking serotonin's emetogenic effects in the chemoreceptor trigger zone and gastrointestinal tract. Common adverse effects are generally mild, including headache, constipation, or diarrhea, with neurological effects like restlessness being rare and atypical for this drug's primary mechanism.
Choice B rationale
Ondansetron should be administered prophylactically, typically 30 minutes *before* chemotherapy, to achieve optimal antiemetic effect. Its mechanism involves blocking serotonin receptors that, when activated by chemotherapy, trigger nausea and vomiting. Pre-emptive administration ensures therapeutic drug levels are present to counteract the emetogenic stimuli effectively before their onset.
Choice C rationale
Acute nausea and vomiting associated with chemotherapy can persist for significantly longer than 12 hours, often lasting for 24 to 48 hours or even longer depending on the specific chemotherapeutic agent and its emetogenic potential. The duration of emesis is highly variable and directly related to the drug's pharmacokinetic profile and the extent of serotonin release.
Choice D rationale
If nausea persists despite ondansetron administration, it indicates an inadequate antiemetic response, likely due to the complex neurochemical pathways involved in chemotherapy-induced nausea and vomiting. This often necessitates a multi-modal approach, involving the addition of other antiemetic agents like corticosteroids (e.g., dexamethasone) or neurokinin-1 receptor antagonists (e.g., aprepitant) to target different emetogenic pathways for more complete symptom control.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.