A nurse is providing teaching to a client who has neuropathic pain and a new prescription for amitriptyline once per day. Which of the following information should the nurse include in the teaching?

Increase fluids while taking the medication.

Expect an elevation in blood pressure with initial doses of the medication.

Stop the medication immediately if urine becomes orange in color.

Take the medication in the morning.

Answer and Explanation

The Correct Answer is A

A. Increase fluids while taking the medication: Amitriptyline is a tricyclic antidepressant that can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps to mitigate these effects and prevent dehydration and constipation.

B. Expect an elevation in blood pressure with initial doses of the medication: Amitriptyline can cause orthostatic hypotension rather than elevated blood pressure. Clients should be informed about the risk of dizziness or fainting.

C. Stop the medication immediately if urine becomes orange in color: Orange urine is not a common side effect of amitriptyline. Clients should not stop the medication without consulting their provider.

D. Take the medication in the morning: Amitriptyline has sedative effects and is typically taken at night to help manage sleep disturbances and reduce daytime drowsiness.

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Correct Answer is D

Explanation

A. Verapamil is a calcium channel blocker that typically decreases heart rate rather than increases it. Therefore, an increased heart rate would not be a therapeutic response to this medication.

B. Verapamil works to lower blood pressure by inhibiting calcium influx into the vascular smooth muscle. An increase in blood pressure would not be an expected therapeutic outcome.

C. While verapamil may help with heart function, the primary therapeutic response is not specifically measured by decreased pulmonary congestion. This outcome may not be directly observable in the early treatment phases post-myocardial infarction.

D. Verapamil is effective in reducing anginal pain by decreasing myocardial oxygen demand through lowering heart rate and contractility. Thus, a decrease in anginal pain would be a direct therapeutic response to the medication.

A. Request a serum trough level blood draw for 60 min after completion of infusion. B. Change the infusion site after each dose administration. C. Contact the provider for prescription clarification. D. Request a serum peak level to be drawn 30 min prior to infusion.

Correct Answer is C

Explanation

A. Requesting a serum trough level blood draw for 60 min after completion of infusion is incorrect. Trough levels should be drawn just before the next dose (not after infusion completion) to ensure therapeutic drug levels and avoid toxicity.
B. Changing the infusion site after each dose administration is incorrect. Vancomycin can cause phlebitis, but routine site changes after every dose are unnecessary unless signs of irritation or infiltration are present.
C. Contacting the provider for prescription clarification is correct. Vancomycin should be infused over at least 60 minutes to reduce the risk of Red Man Syndrome, a histamine reaction that can cause flushing, hypotension, and rash. A 30-minute infusion is too rapid and should be adjusted.
D. Requesting a serum peak level to be drawn 30 min prior to infusion is incorrect. Peak levels are drawn 30–60 minutes after infusion completion, not before infusion. Trough levels, not peak levels, are used to monitor vancomycin dosing.

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A nurse is providing teaching to a client who has neuropathic pain and a new prescription for amitriptyline once per day. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer verapamil to a client who is 2 days post-myocardial infarction. The nurse should monitor the client for which of the following outcomes as a therapeutic response to the medication?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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A nurse is providing teaching to a client who has neuropathic pain and a new prescription for amitriptyline once per day. Which of the following information should the nurse include in the teaching?