A patient who has just begun taking an angiotensin-converting enzyme (ACE) inhibitor calls the nurse and reports feeling very dizzy when standing up, and asks if the medication should be discontinued. What is the nurse's best response?
Stop taking the medication immediately.
Cut the pill in half and take a reduced dosage.
Rise to a sitting or standing position slowly; your symptoms will resolve.
I will schedule you to visit the health care provider today.
The Correct Answer is C
Choice A reason: This is not the best response by the nurse. Stopping the medication abruptly can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.
Choice B reason: This is not the best response by the nurse. Cutting the pill in half and taking a reduced dosage can affect the efficacy and safety of the medication. The patient should not change the dosage of the medication without consulting their health care provider.
Choice C reason: This is the best response by the nurse. Dizziness is a common side effect of ACE inhibitors, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.
Choice D reason: This is not the best response by the nurse. Scheduling the patient to visit the health care provider today is not necessary, unless the dizziness is severe, persistent, or accompanied by other symptoms, such as chest pain, fainting, or palpitations. The patient should be advised to monitor their blood pressure and report any significant changes or concerns to their health care provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not the cause of pulmonary symptoms in left heart failure. Decreased cardiac output is a consequence of left heart failure, which affects the perfusion of vital organs and tissues.
Choice B reason: This is not the cause of pulmonary symptoms in left heart failure. Bronchoconstriction is a feature of asthma and chronic obstructive pulmonary disease (COPD), which affect the airways and cause wheezes and shortness of breath.
Choice C reason: This is not the cause of pulmonary symptoms in left heart failure. Inflammatory pulmonary edema is a type of non-cardiogenic pulmonary edema, which occurs when the alveolar-capillary membrane is damaged by an inflammatory process, such as pneumonia or sepsis.
Choice D reason: This is the correct cause of pulmonary symptoms in left heart failure. Pulmonary vascular congestion is a result of increased pressure in the pulmonary circulation, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes fluid to leak into the alveoli and interstitial spaces, leading to cough, dyspnea, crackles, and pink frothy sputum.
Correct Answer is B
Explanation
Choice A reason: This is not the preferred agent for the initial treatment of heart failure. Vasodilators are a class of medications that lower the blood pressure by relaxing the blood vessels and reducing the resistance to blood flow. They can be used to treat hypertension, angina, and heart failure, but they are usually added to other medications, such as diuretics or beta blockers, to improve the symptoms and outcomes.
Choice B reason: This is the preferred agent for the initial treatment of heart failure. Diuretics are a class of medications that increase the urine output and reduce the fluid retention in the body. They can be used to treat hypertension, edema, and heart failure, as they reduce the preload and afterload on the heart, and decrease the pulmonary congestion and peripheral edema.
Choice C reason: This is not the preferred agent for the initial treatment of heart failure. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias, but they are not recommended for most patients with heart failure, as they may worsen the cardiac function and increase the mortality.
Choice D reason: This is not the preferred agent for the initial treatment of heart failure. Direct renin inhibitors are a class of medications that lower the blood pressure by inhibiting the enzyme renin, which initiates the renin-angiotensin-aldosterone system, a hormonal pathway that regulates the blood pressure and fluid balance. They can be used to treat hypertension, but they have not been proven to be effective or safe for patients with heart failure.
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