A nurse is collecting data from a client prior to administering a calcium channel blocker (CCB) for treatment of hypertension. For which of the following findings should the nurse contact the provider?
Heart rate of 66/min
BP of 148/94 mm Hg
Peripheral edema of the ankles
A digoxin level of 1.2 ng/mL.
The Correct Answer is C
(a) Heart rate of 66/min:
A heart rate of 66/min is within the normal range (60-100 bpm) and does not typically require contacting the provider before administering a calcium channel blocker. CCBs can affect heart rate, but this finding alone is not a contraindication for their use.
(b) BP of 148/94 mm Hg:
A blood pressure reading of 148/94 mm Hg indicates hypertension, which is an appropriate indication for the use of calcium channel blockers. This finding supports the use of the medication rather than requiring the provider to be contacted.
(c) Peripheral edema of the ankles:
Peripheral edema is a known side effect of calcium channel blockers. If the client is already experiencing edema, administering the medication could potentially worsen this condition. The nurse should contact the provider to discuss this finding before proceeding with the medication administration.
(d) A digoxin level of 1.2 ng/mL:
A digoxin level of 1.2 ng/mL is within the therapeutic range (0.5-2.0 ng/mL). This finding does not necessitate contacting the provider before administering a calcium channel blocker, as it does not indicate toxicity or a contraindication for CCB use
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. pH 7.48:
A pH of 7.48 indicates alkalosis, not acidosis. Respiratory acidosis is characterized by a pH below the normal range (7.35-7.45).
B. pH 7.50:
Similar to choice A, a pH of 7.50 indicates alkalosis, not acidosis.
C. pH 7.31:
This pH value falls below the normal range (7.35-7.45), indicating acidemia. In respiratory acidosis, there is an increase in the partial pressure of carbon dioxide (PaCO2) in the blood, leading to an accumulation of carbonic acid and a decrease in pH.
D. pH 7.39:
A pH of 7.39 falls within the normal range (7.35-7.45), indicating a normal acid-base balance. It does not indicate acidosis.
Correct Answer is ["B","C","E"]
Explanation
(A) Decreased stimulation of the sympathetic nervous system (SNS): The sympathetic nervous system (SNS) plays a key role in regulating blood pressure. When the SNS is stimulated, it causes vasoconstriction, or narrowing of the blood vessels, which increases blood pressure. Therefore, decreased stimulation of the SNS would typically lead to vasodilation, or widening of the blood vessels, which would lower blood pressure, not increase it.
(B) Decreased elasticity of blood vessels: As people age, their blood vessels can lose elasticity, which can lead to hypertension. When blood vessels are elastic, they can easily expand and contract with each heartbeat, maintaining a healthy blood pressure. But when they become stiff or rigid, they can’t expand as easily, causing the pressure inside to increase.
(c) Increased peripheral vascular resistance (PVR): Peripheral vascular resistance is the resistance that blood must overcome to flow through the blood vessels. The more resistance, the harder the heart has to work to pump blood through the body, which can lead to increased blood pressure. Factors that can increase PVR include vasoconstriction, or narrowing of the blood vessels, and increased blood viscosity, or thickness.
(D) Decreased fluid volume: Decreased fluid volume, or hypovolemia, would typically lead to a decrease in blood pressure, not an increase. This is because blood pressure is directly related to the volume of blood in the blood vessels. When there’s less blood, the pressure inside the blood vessels is usually lower.
(E) Increased blood viscosity: Blood viscosity refers to the thickness of the blood. When blood is thicker, it’s harder for it to flow through the blood vessels, which increases the resistance to blood flow, leading to increased blood pressure.
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