A patient with type 2 diabetes is taking a beta-blocker as part of treatment for hypertension.
The nurse needs to monitor for which potential complication?
Dehydration.
Hyperkalemia.
Hypoglycemia.
Angina.
The Correct Answer is C
Choice A rationale
Dehydration is not a primary complication directly associated with beta-blocker use. Beta-blockers, such as propranolol or metoprolol, primarily affect the cardiovascular system by blocking beta-adrenergic receptors, which decreases heart rate and blood pressure. Dehydration is typically caused by inadequate fluid intake or excessive fluid loss from conditions like vomiting, diarrhea, or diuresis.
Choice B rationale
Hyperkalemia is an elevated potassium level, which is a rare side effect of non-selective beta-blockers, but not a primary complication to monitor for in a patient taking a beta-blocker for hypertension. Hyperkalemia is more commonly associated with conditions like renal failure or the use of certain medications, such as ACE inhibitors or potassium-sparing diuretics.
Choice C rationale
Beta-blockers can mask the physiological signs of hypoglycemia in patients with diabetes, such as tremors, palpitations, and tachycardia. This occurs because the drugs block the sympathetic nervous system's compensatory response to low blood glucose, which normally involves the release of epinephrine. Consequently, a patient may not recognize a hypoglycemic event until it becomes severe.
Choice D rationale
Angina is a symptom of myocardial ischemia, and beta-blockers are often used to prevent it, not cause it. By reducing the heart rate and contractility, beta-blockers decrease myocardial oxygen demand. This effect helps to prevent chest pain associated with angina, making it a therapeutic benefit rather than a potential complication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Metoprolol is a beta-blocker used for long-term management of angina by reducing myocardial oxygen demand. It is not suitable for immediate relief of an acute anginal attack because its onset of action is slower than that required for rapid symptom resolution.
Choice B rationale
Nitroglycerin is a potent vasodilator that is the preferred medication for immediate relief of acute angina. It works by relaxing vascular smooth muscle, primarily in the veins, leading to a reduction in preload and myocardial oxygen demand, and also dilating coronary arteries.
Choice C rationale
Amlodipine is a long-acting calcium channel blocker used for the prevention of angina. It is not used for acute attacks because its primary effect is on chronic vasodilation and reduction of afterload, and it does not have a rapid onset of action suitable for immediate relief.
Choice D rationale
Aspirin is an antiplatelet agent used to prevent myocardial infarction in patients with coronary artery disease. While it is often administered during a suspected heart attack to reduce clot formation, it does not provide immediate symptomatic relief of anginal pain.
Correct Answer is D
Explanation
Choice A rationale
Giving the insulin is not safe because there is a possibility the patient has already received it, even though the record is not signed. Administering a second dose of insulin could lead to hypoglycemia, a life-threatening condition where the blood glucose level drops dangerously low, causing symptoms like confusion, seizures, and unconsciousness.
Choice B rationale
Holding the insulin is the initial safe action, but simply holding it doesn't resolve the issue and leaves the patient's care plan incomplete. The primary concern is the potential for a double dose and the lack of proper documentation. The problem requires a more formal and structured response than simply holding the medication and moving on.
Choice C rationale
Contacting the night nurse is an option, but it is not the most immediate or appropriate action. The night nurse may be asleep or unreachable. The nurse on duty is responsible for the patient's safety and should follow proper chain of command and reporting protocols to resolve the issue promptly and ensure patient safety.
Choice D rationale
This situation involves a medication discrepancy, a potential medication error, and a significant safety risk to the patient. Reporting it to the nursing supervisor is the correct and necessary action. The supervisor can initiate a formal investigation, ensure the patient is safe, and address the documentation issue to prevent future errors.
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