The nurse is caring for a client with heart failure who is being discharged on lisinopril 10 mg PO bid. Which teaching about this medication should be included in the discharge instructions?

Have blood drawn weekly to check for high magnesium levels

Avoid the use of salt substitutes in your diet

Notify your physician if a headache develops

Take your heart rate daily when on this medication

Answer and Explanation

The Correct Answer is B

A. Have blood drawn weekly to check for high magnesium levels: Lisinopril, an ACE inhibitor, does not significantly affect magnesium levels. Regular monitoring is more important for potassium and renal function (BUN/creatinine), especially in heart failure patients, not magnesium.

B. Avoid the use of salt substitutes in your diet: Lisinopril is an ACE inhibitor. ACE inhibitors can cause potassium retention by reducing the production of aldosterone. Many salt substitutes contain high amounts of potassium chloride and combining the two may lead to hyperkalemia. Patients should be instructed to avoid these substitutes unless approved by their provider.

C. Notify your physician if a headache develops: Headache is a relatively common and usually mild side effect of lisinopril. It does not typically warrant discontinuation or immediate provider notification unless it's severe or persistent with other symptoms like dizziness or visual changes.

D. Take your heart rate daily when on this medication: Lisinopril does not significantly affect heart rate. Monitoring blood pressure is more relevant, as ACE inhibitors are antihypertensives. Heart rate monitoring is more critical with beta blockers or calcium channel blockers.

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Correct Answer is B

Explanation

A. Administer the dose later in the day when their nausea subsides: Delaying the dose does not address the underlying concern of potential digoxin toxicity. Symptoms like nausea and visual disturbances suggest toxicity and require immediate assessment rather than postponement.

B. Assess the client's apical rate: The first and most appropriate nursing action is to assess the apical heart rate for one full minute, as bradycardia is a key indicator of digoxin toxicity. If the rate is below 60 bpm, the dose should be held, and the provider should be notified.

C. Contact the physician for STAT serum potassium level: Hypokalemia increases the risk of digoxin toxicity, but while checking potassium is important, it is not the first step. Assessment of heart rate is more immediately critical in evaluating the need to hold the medication.

D. Administer the client's prescribed dose intravenously: Administering the dose especially IV when the client has symptoms of toxicity could worsen the situation. Digoxin should be held, not given, until further evaluation and provider notification.

A. gabapentin & acetaminophen B. extended release opioids C. sitting & leaning forward D. supine with head of bed 15 degrees

Correct Answer is C

Explanation

A. gabapentin & acetaminophen: While acetaminophen may help with pain relief, gabapentin is primarily used for neuropathic pain and not effective for the inflammatory chest pain associated with pericarditis. These medications do not address the positional nature of pericardial pain.

B. extended release opioids: Opioids may provide general pain relief but are not the standard treatment for pericarditis-related pain. They do not address the inflammatory cause and carry risks of sedation and respiratory depression without improving cardiac inflammation.

C. sitting & leaning forward: Pericarditis pain is classically relieved by having the patient sit up and lean forward. This position reduces pressure on the pericardium and decreases pain by allowing the inflamed pericardial layers to separate slightly, reducing friction.

D. supine with head of bed 15 degrees: Lying flat or even slightly elevated can worsen pericarditis pain because it increases pressure on the inflamed pericardium. Patients often report increased discomfort in the supine position, making it less favorable for symptom relief.

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The nurse is caring for a client with heart failure who is being discharged on lisinopril 10 mg PO bid. Which teaching about this medication should be included in the discharge instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses a client who is prescribed digoxin. The client reports nausea and seeing green halos. Which action should the nurse perform?

Correct Answer is B

Explanation

The nurse understands that chest pain related to pericarditis is classically relieved by

Correct Answer is C

Explanation

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