An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)

Heart sounds.

Blood pressure.

Bowel sounds.

Daily weight.

Range of motion.

Answer and Explanation

Correct Answer : A

Choice A reason:

Heart sounds: Monitoring heart sounds is crucial for evaluating the effectiveness of medications in a client with heart failure and coronary artery disease. Changes in heart sounds, such as the presence of new murmurs or gallops, can indicate worsening heart failure or other cardiac complications1. Regular assessment helps in early detection and management of potential issues.

Choice B reason:

Blood pressure: Blood pressure monitoring is essential for clients with hypertension and those taking medications like atenolol and enalapril. These medications are used to manage blood pressure and reduce the workload on the heart. Regular monitoring ensures that the medications are effectively controlling blood pressure within the target range, typically less than 130/80 mm Hg.

Choice C reason:

Bowel sounds: While assessing bowel sounds is important for overall health, it is not directly related to evaluating the effectiveness of heart failure, CAD, or hypertension medications. Bowel sounds are more relevant in gastrointestinal assessments and do not provide specific information about the effectiveness of the prescribed cardiac medications.

Choice D reason:

Daily weight: Monitoring daily weight is a key assessment for clients with heart failure. Sudden weight gain can indicate fluid retention, which is a sign of worsening heart failure. Furosemide, a diuretic, helps manage fluid balance, and daily weight monitoring helps evaluate its effectiveness in preventing fluid overload.

Choice E reason:

Range of motion: Assessing range of motion is important for overall mobility and physical health but is not directly related to evaluating the effectiveness of medications for heart failure, CAD, or hypertension. It is more relevant in musculoskeletal assessments and rehabilitation.

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Correct Answer is B

Explanation

Choice A reason: Taking tamsulosin early in the day is not necessary. Tamsulosin should be taken approximately 30 minutes after the same meal each day to ensure consistent absorption and effectiveness1. The timing of the dose is less critical than ensuring it is taken after the same meal daily.

Choice B reason: Tamsulosin can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness or fainting. Therefore, it is crucial to instruct patients to stand and sit up slowly to prevent falls and injuries.

Choice C reason: Reducing daily fluid intake is not recommended for patients taking tamsulosin. Adequate hydration is important for overall health and can help manage urinary symptoms associated with BPH. There is no evidence suggesting that fluid restriction improves the effectiveness of tamsulosin.

Choice D reason: Tamsulosin should be taken daily, not on a twice-a-week dosing schedule. Consistent daily dosing is necessary to maintain stable blood levels of the medication and ensure its effectiveness in managing urinary retention due to BPH.

A. Avoid hazardous activities until symptoms subside. B. Increase intake of fluids and high-protein foods. C. Stop taking the medication immediately. D. Obtain transportation to the emergency department.

Correct Answer is A

Explanation

Choice A reason: Baclofen is a muscle relaxant that can cause side effects such as dizziness and fatigue, especially when starting the medication or adjusting the dose1. These symptoms are usually temporary and may subside as the body adjusts to the medication. Advising the client to avoid hazardous activities, such as driving or operating heavy machinery, helps prevent accidents and ensures safety while the body adapts to the new medication.

Choice B reason: Increasing the intake of fluids and high-protein foods is generally good advice for overall health but is not specifically related to managing the side effects of baclofen. While staying hydrated and maintaining a balanced diet can support overall well-being, it does not directly address the dizziness and fatigue caused by baclofen.

Choice C reason: Stopping the medication immediately is not recommended without consulting a healthcare provider. Abruptly discontinuing baclofen can lead to withdrawal symptoms, including hallucinations and seizures4. It is important to follow a healthcare provider’s guidance when adjusting or stopping any medication.

Choice D reason: Obtaining transportation to the emergency department is not necessary unless the symptoms are severe or accompanied by other concerning signs, such as difficulty breathing or chest pain. Mild to moderate dizziness and fatigue are common side effects of baclofen and can typically be managed with caution and monitoring.

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An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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