A patient on beta-blockers for CAD reports fatigue and cold extremities.
What is the most appropriate nursing action?
Discontinue the medication.
Assess vital signs and report findings to the provider.
Increase the dose of the beta-blocker.
Encourage the patient to rest more.
The Correct Answer is B
Choice A rationale
Discontinuing the medication should never be a unilateral nursing decision, as beta-blockers must be tapered off gradually to prevent rebound hypertension, reflex tachycardia, or an acute myocardial infarction. Abrupt cessation can cause a sudden increase in heart rate and blood pressure, putting the patient at significant risk.
Choice B rationale
Fatigue and cold extremities are recognized side effects of beta-blockers, which work by blocking beta-adrenergic receptors, leading to decreased heart rate and vasodilation. Assessing vital signs, especially heart rate and blood pressure, helps determine the severity of the symptoms and whether the medication's therapeutic effects are too pronounced, warranting a dose adjustment by the provider.
Choice C rationale
Increasing the dose would likely worsen the patient's fatigue and cold extremities. These symptoms are dose-dependent effects of beta-blockers, and a higher dose would intensify the medication's physiological impact, leading to a more pronounced decrease in cardiac output and peripheral circulation, exacerbating the patient's discomfort.
Choice D rationale
While rest may provide temporary relief for fatigue, it does not address the underlying pharmacological cause of the symptoms. The patient's fatigue is a direct result of the medication's effect on heart rate and cardiac output. The more appropriate nursing action is to report the findings to the provider for a potential medication or dose change.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Propylthiouracil (PTU) is an antithyroid drug that works by inhibiting the enzyme thyroid peroxidase, which is responsible for the organification and coupling steps of thyroid hormone synthesis. This action reduces the production of new thyroid hormones, making it effective in treating hyperthyroidism.
Choice B rationale
Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. It does not inhibit thyroid hormone production and is not an antithyroid medication; rather, it replaces deficient thyroid hormone, acting in direct opposition to antithyroid drugs.
Choice C rationale
Radioactive iodine is an antithyroid medication used to treat hyperthyroidism. When ingested, it is selectively absorbed by the thyroid gland, where its radiation destroys a portion of the thyroid tissue, thereby reducing the production of thyroid hormones.
Choice D rationale
Methimazole is a thionamide antithyroid drug that inhibits thyroid hormone synthesis by blocking the oxidation of iodide and the coupling of iodotyrosine residues, similar to PTU. It is a common and effective treatment for hyperthyroidism.
Correct Answer is A
Explanation
Choice A rationale
Nitroglycerin works by relaxing vascular smooth muscle, primarily in veins, reducing preload and myocardial oxygen demand. The standard protocol for chest pain is to take one sublingual tablet, and if pain persists, repeat the dose every five minutes for a maximum of three doses in a 15-minute period. If the pain persists after three doses, the patient should seek emergency medical care.
Choice B rationale
Sublingual administration of nitroglycerin is designed for rapid absorption directly into the bloodstream through the mucous membranes under the tongue. Chewing the tablet would lead to slower and less predictable absorption because the medication would be swallowed and metabolized by the liver, reducing its bioavailability and effectiveness.
Choice C rationale
Nitroglycerin is a volatile compound that is sensitive to heat, light, and moisture. Storing the medication in a humid environment can cause it to lose its potency, rendering it ineffective when needed to treat acute angina. It should be kept in its original dark glass container, tightly capped, in a cool, dry place.
Choice D rationale
Alcohol can potentiate the hypotensive effects of nitroglycerin, leading to a significant and potentially dangerous drop in blood pressure. Combining these substances can cause severe orthostatic hypotension, syncope, and an increased risk of falls, making it a dangerous interaction that patients should be explicitly warned against.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.