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 A

Explanation

A. Benign Prostatic Hyperplasia: Tamsulosin is an alpha-1 adrenergic blocker specifically prescribed to relieve urinary symptoms caused by benign prostatic hyperplasia (BPH). It works by relaxing the smooth muscles in the bladder neck and prostate, improving urine flow and decreasing bladder outlet obstruction.

B. Congestive Heart Failure: Tamsulosin is not indicated for heart failure management. Medications used in heart failure typically include ACE inhibitors, beta blockers, diuretics, and aldosterone antagonists not selective alpha-1 blockers like tamsulosin.

C. Rheumatic Fever: Rheumatic fever is linked to valvular heart disease, not urinary retention or prostate enlargement. Tamsulosin does not have a role in its treatment or management.

D. Coronary Artery Disease: Tamsulosin does not have any therapeutic effect in managing coronary artery disease. CAD is typically managed with medications such as beta blockers, statins, antiplatelets, and nitrates, depending on the clinical scenario.

A. Administer amiodarone 200 mg IV push B. Defibrillate the client using 200 joules C. CPR until the physician stops the code D. Administer adenosine 12 mg IV push

Correct Answer is C

Explanation

A. Administer amiodarone 200 mg IV push: Amiodarone is used for shockable rhythms like ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) that are refractory to defibrillation. The rhythm on the monitor is asystole, which is non-shockable, and amiodarone is not indicated here.

B. Defibrillate the client using 200 joules: Defibrillation is only appropriate for shockable rhythms such as VF or pulseless VT. Asystole is not shockable, and defibrillation in this rhythm would be ineffective and inappropriate.

C. CPR until the physician stops the code: The rhythm strip shows asystole, a flatline with no electrical activity. The priority intervention is to initiate and continue high-quality cardiopulmonary resuscitation (CPR) immediately and continue until the code is terminated by the physician. This is consistent with Advanced Cardiac Life Support (ACLS) guidelines.

D. Administer adenosine 12 mg IV push: Adenosine is used to terminate supraventricular tachycardia (SVT) and is not indicated in asystole or during cardiac arrest. It would have no effect in a rhythm with no electrical activity.

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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

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