The nurse is caring for a patient taking diltiazem for blood pressure management. The nurse instructs the patient to report which side effect to the provider?

Dry skin

Burning sensation

Diarrhea

Irregular heart rate

Answer and Explanation

The Correct Answer is D

A. Dry skin:
Dry skin is not a commonly reported side effect of diltiazem, a calcium channel blocker used for blood pressure management. While dry skin can occur due to various reasons, it is less likely to be directly associated with diltiazem use. Therefore, it is not the side effect that the nurse should prioritize instructing the patient to report to the provider.

B. Burning sensation:
Although burning sensation is not a common side effect of diltiazem, it can occasionally occur as a skin reaction or hypersensitivity reaction to the medication. While this symptom may warrant attention, it is generally less concerning compared to other potential side effects of diltiazem. Therefore, while it is important for the patient to report any unusual sensations or discomfort, burning sensation alone may not be the most critical side effect to report.

C. Diarrhea:
Diarrhea is a potential side effect of diltiazem use. Calcium channel blockers like diltiazem can affect gastrointestinal motility and lead to gastrointestinal disturbances, including diarrhea. While diarrhea can be bothersome and may indicate intolerance to the medication, it is generally considered a common side effect rather than a severe adverse reaction. Therefore, while the nurse should educate the patient about the possibility of diarrhea and encourage reporting any persistent or severe cases, it may not be the most critical side effect to report to the provider.

D. Irregular heart rate:
Irregular heart rate, including bradycardia or tachycardia, is a significant and potentially serious side effect of diltiazem. As a calcium channel blocker, diltiazem can affect cardiac conduction, leading to alterations in heart rate and rhythm. Irregular heart rate can indicate a significant cardiovascular complication and may require prompt medical attention. Therefore, the nurse should prioritize instructing the patient to report any changes in heart rate, including palpitations, rapid heartbeat, or irregular pulse, to the provider immediately.

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Correct Answer is C

Explanation

A. Continue to administer the metoprolol tartrate as ordered:
Metoprolol is a beta-blocker commonly used to treat hypertension, angina, and heart failure. One of its main effects is to decrease heart rate and blood pressure. In this scenario, the patient's vital signs reveal a low heart rate (48 bpm) and relatively low blood pressure (100/50 mmHg). Given that metoprolol can further reduce heart rate and blood pressure, it would be prudent for the nurse to withhold the medication until further assessment is conducted.

B. Ask the patient if her pulse is within the normal range:
While it's essential to assess the patient's understanding of her condition, asking if her pulse is within the normal range is not sufficient. The nurse should perform a more thorough assessment and consider the clinical significance of the vital signs obtained. In this case, a heart rate of 48 bpm is lower than the typical normal range for adults (60-100 bpm), indicating bradycardia, which may be symptomatic or concerning in the context of administering a beta-blocker like metoprolol.

C. Hold the medication and call the provider:
Given the patient's low heart rate (bradycardia) and relatively low blood pressure, holding the metoprolol tartrate and contacting the healthcare provider is the most appropriate action. Bradycardia and hypotension can be signs of excessive beta-blockade, especially with medications like metoprolol, which can further lower heart rate and blood pressure. The nurse should notify the provider promptly to discuss the patient's condition and determine the appropriate course of action.

D. Ask the patient to eat salty foods:
Encouraging the patient to eat salty foods would not address the underlying issue of bradycardia and hypotension. While increasing salt intake may help raise blood pressure in some cases, it is not a standard intervention for managing symptomatic bradycardia or low blood pressure caused by medication effects.

A. Assess nutritional status with height, weight, blood urea nitrogen, transferrin, hemoglobin and hematocrit level. B. Consult with dietitian to determine patient's nutritional needs. C. Encourage patient to prepare simple meals or to obtain assistance with meal preparation if possible. D. Encourage patient to eat meals with visitors or others when possible.

Correct Answer is C

Explanation

A. Assess nutritional status with height, weight, blood urea nitrogen, transferrin, hemoglobin, and hematocrit level: This option focuses on assessing the patient's nutritional status, which is important for planning appropriate interventions. However, in a patient presenting with severe diarrhea and vomiting, the priority is to address immediate physiological needs and stabilize the patient's condition before conducting comprehensive assessments. While assessing nutritional status is important for long-term management, it is not the first action the nurse should take in this acute situation.

B. Consult with a dietitian to determine the patient's nutritional needs: Consulting with a dietitian is an important step in addressing the patient's nutritional needs, especially in cases of prolonged diarrhea and vomiting. However, in this scenario, the patient is experiencing severe symptoms that require immediate attention. Before consulting with a dietitian, the nurse should address the patient's acute symptoms and initiate interventions to manage fluid and electrolyte imbalances.

C. Encourage the patient to prepare simple meals or to obtain assistance with meal preparation if possible: This option addresses the immediate need to provide nutritional support to the patient. Encouraging the patient to consume simple, easily digestible meals or to seek assistance with meal preparation helps ensure that the patient receives adequate nutrition despite experiencing symptoms of diarrhea and vomiting. Providing practical advice on meal preparation empowers the patient to take control of their nutritional intake, which can be beneficial in managing symptoms and promoting recovery.

D. Encourage the patient to eat meals with visitors or others when possible: While social support and companionship can have a positive impact on the patient's overall well-being, including their nutritional intake, this option is not the first priority in this scenario. The patient's severe symptoms of diarrhea and vomiting require immediate attention to address fluid and electrolyte imbalances and prevent complications such as dehydration. Once the patient's condition stabilizes, encouraging social interaction during meals can be beneficial for promoting nutritional intake and emotional support.

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The nurse is caring for a patient taking diltiazem for blood pressure management. The nurse instructs the patient to report which side effect to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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