Patient Data

History and Physical

The client is a 34-year-old male with a history of seasonal allergies and asthma. He was jogging this morning and became short of breath. He took one puff of an "emergency inhaler" but is unsure of the name of the medication. Upon exam, the client is anxious, tachypneic, tachycardic, and wheezing.

Review history.

Which 2 drugs would be the most appropriate to give the client now?

A. Document the assessment findings in the electronic health record: Riluzole is not curative for ALS; it only modestly slows disease progression. Continuing muscle weakness and atrophy are expected findings in ALS, even after starting treatment. Accurate documentation is appropriate because no immediate change in therapy is indicated based solely on these observations.

B. Explain that the medication takes several weeks to reverse symptoms: Riluzole does not reverse ALS symptoms. It may slightly prolong survival by slowing the progression of muscle weakness, but it does not regenerate lost function or reverse disease-related damage.

C. Advise the client to schedule an appointment for liver function tests: Riluzole can affect liver function and periodic monitoring is important, but muscle weakness alone does not directly signal liver problems. Unless there are signs of hepatotoxicity, there is no immediate need for unscheduled testing.

D. Withhold the medication until the healthcare provider is notified: There is no indication to withhold riluzole based on ongoing muscle weakness, as this is consistent with the natural course of ALS. Interrupting therapy without a clear medical reason could harm the client.

• Increasing heart rate: Increasing heart rate is not the mechanism of thiazide diuretics or ACE inhibitors. It would raise blood pressure by increasing cardiac workload. Effective antihypertensives aim to lower or stabilize heart rate, not increase it.
• Reducing stroke volume: Thiazide diuretics reduce stroke volume by lowering blood volume through sodium and water excretion. This decreases cardiac output and helps lower blood pressure, particularly in volume-sensitive hypertension.
• Suppressing the appetite: Suppressing appetite is unrelated to the action of thiazide diuretics or ACE inhibitors. These drugs target fluid balance and vascular tone, not the central nervous system mechanisms that regulate hunger.
• Decreasing serum sodium levels: Both thiazide diuretics and ACE inhibitors contribute to decreased serum sodium levels, which helps lower blood volume. This reduction supports blood pressure control but must be monitored to avoid hyponatremia.
• Reducing systemic vascular resistance: ACE inhibitors lower blood pressure by reducing systemic vascular resistance through vasodilation. Blocking angiotensin II prevents arterial constriction, easing the workload on the heart and lowering afterload.