The nurse is caring for a client with frequent dizziness. The nurse is evaluating the client for postural hypotension. Which of the following symptoms would indicate a potential diagnosis?

A drop in diastolic blood pressure (25 mmHg) upon rising

A pulsating headache

A blood pressure elevation upon activity

A drop in systolic blood pressure (15 mm Hg) upon rising

Answer and Explanation

The Correct Answer is A

A. A drop in diastolic blood pressure (25 mmHg) upon rising: Orthostatic (postural) hypotension is diagnosed by a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing. A 25 mmHg drop in diastolic pressure is a significant change and meets criteria for this condition.
B. A pulsating headache: While a headache may accompany blood pressure fluctuations, it is not a defining symptom of postural hypotension. It lacks the diagnostic specificity needed to confirm this condition.
C. A blood pressure elevation upon activity: An increase in blood pressure during activity is expected and not diagnostic of postural hypotension. In fact, postural hypotension involves a blood pressure drop upon standing, not a rise.
D. A drop in systolic blood pressure (15 mm Hg) upon rising: A 15 mmHg systolic drop does not meet the threshold for orthostatic hypotension. For diagnosis, the systolic pressure must drop by at least 20 mmHg within 3 minutes of standing.

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Correct Answer is C

Explanation

A. Multivitamins: Most multivitamins do not interact significantly with MAOIs unless they contain high levels of tyramine, which is rare. They are generally safe but should still be reviewed by the healthcare provider.
B. Laxatives: Laxatives are not known to have direct interactions with MAOIs. However, excessive use could alter electrolyte balance, which might complicate overall medication management but not specifically with MAOIs.
C. Cold and allergy medications: Many over-the-counter cold and allergy drugs contain sympathomimetic agents like pseudoephedrine, which can cause hypertensive crises. This is because these decongestatnts increase norepinephrine levels while MAOIs prevent the breakdown of norepinephrine. This combination is dangerous and must be strictly avoided.
D. Antiulcer medications: Most antiulcer drugs, such as proton pump inhibitors and H2 blockers, do not significantly interact with MAOIs. They should still be reviewed, but they are not commonly contraindicated.

A. "Chest pain should always be evaluated." B. "But you are okay now." C. "It must have been frightening for you." D. "We would not let you die."

Correct Answer is C

Explanation

A. "Chest pain should always be evaluated.": While true, this response shifts focus away from the client’s emotional experience. It is more clinical than empathetic, and may not validate the client's current distress.
B. "But you are okay now.": This can feel dismissive of the intense fear the client experienced. While intended to reassure, it overlooks the need for emotional validation during recovery from a panic attack.
C. "It must have been frightening for you.": This statement acknowledges and validates the client’s emotional experience. Empathic reflection helps reduce shame and fosters therapeutic rapport during an anxiety crisis.
D. "We would not let you die.": This response may sound comforting but unintentionally minimizes the client’s perceived fear and lacks therapeutic depth. It doesn’t address the emotional intensity of the situation.

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The nurse is caring for a client with frequent dizziness. The nurse is evaluating the client for postural hypotension. Which of the following symptoms would indicate a potential diagnosis?

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Explanation

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Explanation

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