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.

Correct Answer is ["0.2"]

Explanation

Calculating the Morphine Sulfate Dose:Problem: Administer 2 mg of morphine sulfate IV bolus. The available concentration is 10 mg/mL.

Steps:

Set up a proportion:

We want to find the number of milliliters (mL) needed.

We know the desired dose (2 mg) and the concentration of the medication (10 mg/mL).

Proportion:

x mL / 2 mg = 1 mL / 10 mg

Cross-multiply:

10x = 2

Solve for x:

x = 2 / 10

x = 0.2

Answer: The nurse should administer 0.2 mL of morphine sulfate per dose.

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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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Naxlex Comprehensive Predictor Exams

A nurse is teaching a class about pharmacodynamics. The nurse should include that which of the following medication levels occurs when a medication is at the lowest serum concentration?

Correct Answer is D

Explanation

A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.2"]

Explanation

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