A nurse is preparing to administer an alpha blocker for the first time.
What is the most important adverse effect for the nurse to assess the patient for?
Renal failure.
Hypotension.
Blood dyscrasia.
Dysrhythmias.
The Correct Answer is B
Choice A rationale
Renal failure is not a common or expected adverse effect of alpha-blockers. While a drop in blood pressure could theoretically impact kidney perfusion, renal failure is not the primary adverse effect that the nurse should assess for, especially when the medication is administered for the first time. The nurse should be focused on the most common and immediate side effects of the drug.
Choice B rationale
Alpha-blockers, such as prazosin or terazosin, work by blocking alpha-1 adrenergic receptors, which causes vasodilation and a decrease in peripheral vascular resistance. The most significant adverse effect upon the first dose is a profound drop in blood pressure, known as first-dose hypotension, which can lead to dizziness, syncope, and falls. The nurse must assess for this effect by monitoring blood pressure and advising the patient to change positions slowly.
Choice C rationale
Blood dyscrasias, such as neutropenia or thrombocytopenia, are not common adverse effects of alpha-blockers. These are more frequently associated with certain other drug classes like antithyroid medications or some psychiatric medications. While all medications have a risk of adverse effects, blood dyscrasias are not the primary concern for the nurse when administering an alpha-blocker for the first time.
Choice D rationale
While some medications can cause dysrhythmias, this is not the most common or immediate adverse effect to assess for with the first dose of an alpha-blocker. The primary and most direct physiological effect of these medications is vasodilation, which leads to hypotension. Dysrhythmias are a more likely side effect of other cardiovascular drugs, such as beta-blockers, not alpha-blockers.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While a dry cough is a common side effect of ACE inhibitors, it should not be simply dismissed. The cough is caused by the accumulation of bradykinin, a substance that is normally degraded by the enzyme that ACE inhibitors block. This cough can be very bothersome to patients, and in some cases, can progress and may warrant a change in medication.
Choice B rationale
Increasing fluid intake is a supportive measure for many types of coughs, but it does not address the underlying pharmacological cause of an ACE inhibitor-induced cough. The cough is a direct result of bradykinin accumulation in the lungs, and simply drinking more water will not reduce this level or resolve the cough. The appropriate action involves addressing the root cause.
Choice C rationale
The cough associated with ACE inhibitors is a known side effect that occurs due to the accumulation of bradykinin. This side effect is often a significant reason for discontinuation. The most appropriate nursing action is to report the finding to the healthcare provider so they can evaluate the patient and consider alternative therapies, such as an angiotensin II receptor blocker (ARB), which does not affect bradykinin levels.
Choice D rationale
Discontinuing the medication immediately is not the appropriate action. While a cough can be bothersome, it is not a life-threatening emergency. Abruptly stopping the medication, especially in a patient with a history of hypertension or heart failure, could lead to a sudden and dangerous increase in blood pressure or a worsening of their underlying condition. The decision to discontinue or change medication must be made by the healthcare provider.
Correct Answer is A
Explanation
Choice A rationale
When administering an alpha-adrenergic drug for hypertension, the nurse should assess for hypertension. This is because these drugs are used to lower blood pressure, and a therapeutic effect would be a decrease in blood pressure, not an increase. If blood pressure increases, the medication may be ineffective or another issue may be present.
Choice B rationale
Alpha-adrenergic drugs do not directly cause hyperkalemia. Hyperkalemia is a high level of potassium in the blood, and while certain medications can affect potassium levels, this is not a common side effect associated with alpha-adrenergic drugs.
Choice C rationale
Oliguria is decreased urine output. Alpha-adrenergic drugs do not typically cause oliguria. Some antihypertensives might affect kidney function, but a significant decrease in urine output is not a primary or common side effect and is more associated with kidney problems.
Choice D rationale
Respiratory distress is not a common or expected side effect of alpha-adrenergic drugs used for hypertension. These drugs primarily act on the vascular system. Respiratory distress is more commonly associated with conditions like asthma or severe allergic reactions.
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