Question 9

The nurse is preparing medications for a client with a history of hypertension that is post-op day 3 following hip replacement.

Meds: Atenolol 25 mg PO, Captopril 10 mg PO, Glipizide 5 mg PO, Atorvastatin 20 mg PO, and Enoxaparin 40 mg SQ.

Vital signs: blood pressure 138/90, heart rate 82, respiratory rate 18, temperature 99.7, O2 saturation 96% on room air.

Today's labs: sodium- 143 meq/L, potassium 6.2 mmol/L, hemoglobin 11.1 gm/dL, platelets 104,000, white blood count 10.8, blood glucose 130.

Which medication would be a priority for the nurse to hold?

Choice A reason: This statement is false. Glucagon is not a drug that the nurse should assess prior to sending the client to radiology, as glucagon is used to treat severe hypoglycemia, which is unlikely to occur during the procedure. Glucagon is an injectable hormone that raises blood glucose levels by stimulating the breakdown of glycogen in the liver.

Choice B reason: This statement is false. Famotidine is not a drug that the nurse should assess prior to sending the client to radiology, as famotidine is used to treat gastroesophageal reflux disease, peptic ulcer disease, or gastritis, which are not related to the procedure. Famotidine is an oral medication that reduces the production of stomach acid by blocking histamine receptors in the stomach.

Choice C reason: This statement is true. Metformin is a drug that the nurse should assess prior to sending the client to radiology, as metformin is used to treat type 2 diabetes, which can interact with the contrast dye used in the procedure. Metformin is an oral medication that lowers blood glucose levels by decreasing the absorption of glucose in the intestines, increasing the uptake of glucose in the muscles, and reducing the production of glucose in the liver. However, metformin can also cause lactic acidosis, a serious condition that occurs when there is too much acid in the blood. The contrast dye can impair the kidney function and increase the risk of lactic acidosis. Therefore, the nurse should check the client's renal function tests and inform the radiologist if the client is taking metformin. The client may need to stop taking metformin before and after the procedure, depending on the instructions from the prescriber.

Choice D reason: This statement is false. Forge is not a drug that the nurse should assess prior to sending the client to radiology, as forge is not a real medication. It is a misspelling of Forxiga, which is another oral medication used to treat type 2 diabetes. Forxiga works by increasing the excretion of glucose in the urine by inhibiting a protein called sodium-glucose co-transporter 2 in the kidneys. Forxiga does not have a significant interaction with the contrast dye, but the nurse should still monitor the client's blood glucose levels and hydration status before and after the procedure.

Choice A reason: This statement is false. Atorvastatin is not a medication that the nurse should hold, as it is used to lower cholesterol and prevent cardiovascular events. It does not have a significant effect on blood pressure, heart rate, or blood glucose.

Choice B reason: This statement is true. Captopril is a medication that the nurse should hold, as it is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents kidney damage. However, it can also cause hyperkalemia, which is a condition where the potassium level is too high. The client has a high potassium level, which can cause cardiac arrhythmias or muscle weakness. The nurse should hold the captopril and notify the prescriber.

Choice C reason: This statement is false. Atenolol is not a medication that the nurse should hold, as it is a beta-blocker that lowers blood pressure and heart rate. It can also prevent angina and reduce the risk of heart attack. The client has a normal heart rate and a slightly elevated blood pressure, which can be expected after surgery. The nurse should monitor the client's vital signs and administer the atenolol as ordered.

Choice D reason: This statement is false. Glipizide is not a medication that the nurse should hold, as it is an oral antidiabetic drug that lowers blood glucose by stimulating the release of insulin from the pancreas. The client has a normal blood glucose level, which can be maintained by taking the glipizide as ordered. The nurse should also encourage the client to follow a balanced diet and exercise regimen.