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 B

Explanation

A) "This hospital might use a different manufacturer, but the medication is the same":
While this response provides reassurance about the consistency of the medication, it does not directly engage with the client’s observation. It may not fully address the client's specific concerns or help in verifying whether the medication is indeed correct.

B) "Describe what the pill looks like":
Asking the client to describe the pill helps in verifying its identity. This response is appropriate because it allows for a comparison between the pill in question and the medication the client is familiar with, ensuring that the right medication is being administered.

C) "This is the medication prescribed by your provider":
This response confirms that the medication is prescribed but does not address why it looks different. It may not provide the necessary reassurance or clarification about the appearance of the medication.

D) "This pill is probably from a different lot number than yours at home":
Although this response could explain the appearance difference, it might not be as reassuring as verifying the medication’s identity. It’s more important to ensure that the client’s concern is addressed directly by comparing the appearance of the medication.

Correct Answer is ["100"]

Explanation

Calculating the IV Infusion Rate

Problem: Administer 300 mg of clindamycin IV over 30 minutes. The available solution is 300 mg in 50 mL of 0.9% NaCl.

Steps:

Convert minutes to hours:

30 minutes x (1 hour / 60 minutes) = 0.5 hours

Calculate the infusion rate:

50 mL / 0.5 hours = 100 mL/hour

Answer: The nurse should set the IV pump to deliver 100 mL/hour.

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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.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a medication to a client who states, "That looks different from the pill I usually take." Which of the following responses should the nurse make?

Correct Answer is B

Explanation

Correct Answer is ["100"]

Explanation

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