A patient begins taking the calcium channel blocker, nifedipine [Procardia], along with metoprolol, to treat hypertension. The nurse understands that metoprolol is used to:

Choice A reason: Dry mouth is a relatively minor side effect of statin medications and is generally not a cause for significant concern. While it can be uncomfortable and may affect oral health if persistent, it does not typically indicate a serious underlying condition.

Choice B reason: Diarrhea can be an inconvenient and uncomfortable side effect of statins, but it is not usually considered dangerous. It is important to manage it to prevent dehydration and electrolyte imbalances, but it is not as concerning as some other side effects.

Choice C reason: Muscle pain, also known as myalgia, is the most concerning side effect of statin medications like simvastatin. In rare cases, muscle pain can progress to a more serious condition called rhabdomyolysis, where muscle tissue breaks down rapidly, releasing a protein called myoglobin into the bloodstream. This can lead to kidney damage and, in severe cases, kidney failure. Therefore, any new or unexplained muscle pain should be promptly reported to a healthcare provider for evaluation.

Choice D reason: Headache is a common and generally mild side effect of many medications, including statins. While it can be bothersome, it is not typically indicative of a serious problem and is not considered as concerning as muscle pain related to statin use.

Choice A reason: Cirrhosis of the liver is the most common cause of portal hypertension. Cirrhosis involves the scarring of liver tissue, which obstructs blood flow through the liver and increases pressure in the portal vein. This increased pressure can lead to complications such as varices (enlarged veins) that can rupture and cause bleeding, such as vomiting blood (hematemesis). The liver's inability to properly manage blood flow due to scar tissue buildup is central to the development of portal hypertension.

Choice B reason: Left ventricular failure can lead to pulmonary hypertension (increased pressure in the pulmonary arteries) but is not a common cause of portal hypertension. Portal hypertension specifically refers to increased pressure in the portal vein system, which is most often due to liver disease. Left ventricular failure affects the heart and lungs, not the liver or its blood vessels, thus not leading to the observed condition of portal hypertension.

Choice C reason: Renal stenosis refers to the narrowing of the arteries that supply blood to the kidneys, which can lead to hypertension (high blood pressure) but not portal hypertension. Portal hypertension is related to the liver and its blood flow, not the renal arteries. Renal stenosis primarily causes problems in the kidney's function and systemic blood pressure rather than affecting the portal vein system.

Choice D reason: Thrombosis in the spleen can cause localized issues but is not a common cause of portal hypertension. Portal hypertension is typically related to liver conditions, such as cirrhosis, which affect the blood flow through the liver and portal vein system. Thrombosis in the spleen might complicate portal vein blood flow but is not a primary cause like liver cirrhosis is.