A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.)

Duloxetine

Furosemide

Telmisartan

Atorvastatin

Clopidogrel

Answer and Explanation

Correct Answer : A,B,C

A) Duloxetine: Duloxetine, an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor), is commonly used for depression and chronic pain. It can cause orthostatic hypotension, especially in older adults, due to its effects on norepinephrine, which can lead to blood pressure fluctuations upon standing.

B) Furosemide: Furosemide is a loop diuretic that increases urine output, leading to a decrease in blood volume. This reduction in blood volume can result in orthostatic hypotension, particularly when the client changes positions quickly, such as moving from lying down to standing.

C) Telmisartan: Telisartan is an angiotensin II receptor blocker (ARB) used to treat hypertension. It can cause vasodilation and a reduction in blood pressure, which may lead to orthostatic hypotension, especially in older adults who are more sensitive to blood pressure changes.

D) Atorvastatin: Atorvastatin, a statin used to lower cholesterol, does not typically cause orthostatic hypotension. Its primary action is on lipid levels rather than blood pressure, making it less likely to contribute to this condition.

E) Clopidogrel: Clopidogrel is an antiplatelet medication that reduces the risk of blood clots. It does not generally affect blood pressure or cause orthostatic hypotension, as its mechanism of action is related to inhibiting platelet aggregation rather than influencing vascular tone or fluid balance.

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Correct Answer is D

Explanation

D) Trough:
The trough level of a medication is the lowest concentration of the drug in the bloodstream before the next dose is administered. Monitoring the trough level helps ensure that the medication stays within a therapeutic range, minimizing the risk of toxicity and ensuring effectiveness.

A) Half-life:
Half-life refers to the time it takes for the concentration of a drug in the blood to decrease by half. It is related to how long the drug stays in the system but does not specifically indicate the lowest concentration.

B) Peak:
The peak level is the highest concentration of the drug in the bloodstream after administration. It is used to assess the maximum effect of the drug, not the lowest concentration.

C) Toxic:
Toxic level refers to the concentration of a drug at which it can cause adverse effects or toxicity. It is not related to the lowest concentration but rather to potentially harmful levels.

A. Provide educational material written at a 9th grade reading level. B. Begin the session with the least important information. C. Use active listening methods during the session. D. Ask the client open-ended questions during the session. E. Use the teach-back method during the session.

Correct Answer is ["C","D","E"]

Explanation

C) Use active listening methods during the session:
Active listening is crucial in educational sessions as it ensures the nurse fully understands the client’s needs and concerns. It involves attentively listening to the client, responding to their questions, and adapting the teaching to their feedback. This fosters effective communication and enhances learning.

D) Ask the client open-ended questions during the session:
Open-ended questions encourage clients to express their thoughts and provide more detailed responses. This approach helps the nurse assess the client’s understanding and identify any areas where further explanation might be needed. It also promotes a more interactive and engaging teaching process.

E) Use the teach-back method during the session:
The teach-back method involves asking the client to repeat the information in their own words to confirm their understanding. This technique is effective in reinforcing learning and identifying any gaps in the client’s comprehension, ensuring they are well-informed about their medication.

A) Provide educational material written at a 9th-grade reading level:
While providing educational material at an appropriate reading level is important, it is not selected here because the question focuses on strategies to use during the teaching session rather than the written material itself.

B) Begin the session with the least important information:
Beginning with the least important information is not an effective teaching strategy. It is better to start with the most critical points to ensure the client understands the essential aspects of their medication.

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A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.)

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