A nurse is caring for a client who has heart failure and a new prescription for lisinopril.
For which of the following adverse effects should the nurse monitor when administering lisinopril?
Tinnitus.
Hypotension.
Hypokalemia.
Bradycardia.
The Correct Answer is B
Lisinopril is an angiotensin converting enzyme (ACE) inhibitor that is used to treat high blood pressure and heart failure. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. However, one of the common side effects of lisinopril is hypotension, which means low blood pressure. Hypotension can cause dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. Therefore, the nurse should monitor the client’s blood pressure when administering lisinopril and report any signs of hypotension to the doctor.
Choice A is wrong because tinnitus, which means ringing or buzzing in the ears, is not a common or serious side effect of lisinopril.
Tinnitus can be caused by other factors such as ear infections, loud noises, or medications such as aspirin or antibiotics.
Choice C is wrong because hypokalemia, which means low potassium levels in the blood, is not a common or serious side effect of lisinopril. In fact, lisinopril can cause hyperkalemia, which means high potassium levels in the blood, especially in patients with kidney problems or diabetes. Hyperkalemia can cause irregular heartbeats, muscle weakness, or numbness. Therefore, the nurse should monitor the client’s potassium levels when administering lisinopril and avoid giving potassium supplements or salt substitutes that contain potassium.
Choice D is wrong because bradycardia, which means slow heart rate, is not a common or serious side effect of lisinopril.
Lisinopril does not affect the heart rate directly, but it can lower the blood pressure and improve the heart function.
Bradycardia can be caused by other factors such as heart block, sinus node dysfunction, or medications such as beta blockers or calcium channel blockers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.
Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL.
A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.
Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L.
Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.
Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification of the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.
Choice B is correct because difficulty hearing or hearing loss is a rare but serious side effect of furosemide that may indicate ototoxicity (damage to the inner ear). This can be irreversible if not treated promptly and may affect the client’s quality of life and safety. The nurse should notify the provider immediately if the client reports difficulty hearing or any other signs of ototoxicity, such as ringing in the ears (tinnitus) or vertigo (a sensation of spinning). The provider may need to adjust the dose of furosemide or switch to another diuretic that is less ototoxic.
Correct Answer is A
Explanation
This is because the umbilicus is a potential site of infection and should be avoided when administering subcutaneous heparin.
Choice B is wrong because massaging the site after administering the medication can cause bruising and hematoma formation.
Choice C is wrong because a 21-gauge needle is too large for subcutaneous injection and can cause tissue trauma and bleeding.
A smaller needle, such as 25- or 27-gauge, should be used.
Choice D is wrong because aspirating before injecting the medication can increase the risk of hematoma formation and is not recommended for subcutaneous heparin.
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