The nurse is caring for an 80-year-old patient who has just begun taking a Thiazide diuretic to treat hypertension.
What is an important aspect of care for this patient?
Providing a low potassium diet.
Encouraging increased fluid intake.
Initiating a fall risk protocol.
Increasing exercise and activity.
The Correct Answer is C
Choice A rationale
Thiazide diuretics can lead to hypokalemia, thus a low potassium diet is not recommended. Instead, patients should consume potassium-rich foods to maintain electrolyte balance.
Choice B rationale
Thiazide diuretics increase urine output, which can lead to dehydration. Encouraging increased fluid intake helps to prevent dehydration and maintain proper fluid balance.
Choice C rationale
Thiazide diuretics can cause dizziness or lightheadedness, increasing the risk of falls, especially in elderly patients. Initiating a fall risk protocol is important to ensure patient safety.
Choice D rationale
While exercise is beneficial, thiazide diuretics can cause weakness and dizziness, making it important to assess the patient’s tolerance and monitor their response to physical activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
This choice is incorrect. A complete occlusion of a coronary vessel results in a myocardial infarction (heart attack), not unstable angina. Unstable angina occurs when there is a significant narrowing or partial blockage of a coronary artery, leading to reduced blood flow and oxygen supply to the heart muscle, causing pain or discomfort. Complete occlusion would cause permanent damage to the heart muscle, which is not the case with unstable angina.
Choice B rationale
This choice is correct. While unstable angina is mainly caused by narrowing of the coronary arteries, it can also be caused by a spasm of the blood vessel. This spasm, also known as vasospasm, reduces the amount of blood flow to the heart muscle, resulting in pain. These spasms can occur even if the coronary arteries do not have significant plaque buildup, adding another layer of complexity to the condition.
Choice C rationale
This choice is partially correct. The body’s response to a lack of oxygen (ischemia) in the heart muscle does result in pain, known as angina. However, this choice does not fully capture the specific nature of unstable angina, which involves episodes of pain that occur more frequently and are more severe than those associated with stable angina, and can occur at rest or with minimal exertion, indicating a higher risk for a heart attack.
Choice D rationale
This choice is correct. Unstable angina is characterized by a serious narrowing of a coronary artery that reduces oxygen supply to the heart. This narrowing is typically due to atherosclerotic plaque and can be complicated by blood clots or spasms. Unlike stable angina, the pain of unstable angina is more unpredictable and can occur without a triggering factor like exercise or stress, signaling a higher risk of a heart attack.
Correct Answer is A
Explanation
Choice A rationale
This choice is correct. The side effects of paroxetine, including headaches, nervousness, and poor appetite, are common during the initial weeks of treatment and often decrease over time as the patient’s body adjusts to the medication. Reassuring the patient helps them continue the treatment without undue anxiety about these side effects, which are typically transient and manageable.
Choice B rationale
This choice is incorrect. Abruptly stopping paroxetine without consulting a healthcare provider is not recommended because it can lead to withdrawal symptoms and a possible relapse of depression or anxiety. The patient should only discontinue the medication under the guidance of a healthcare provider, who may suggest a gradual tapering off process to minimize withdrawal symptoms.
Choice C rationale
This choice is partially correct. Taking paroxetine with food can help mitigate some gastrointestinal side effects, such as nausea. However, it does not directly address headaches, nervousness, or poor appetite. Although taking the medication with food is a useful tip, it is not the most comprehensive advice for this particular situation.
Choice D rationale
This choice is incorrect. While adjusting the dose may be an option, it is premature to suggest this after only two weeks of treatment. The patient’s body may still be adjusting to the medication, and many side effects diminish with time. The decision to change the dosage should be made by the healthcare provider based on a thorough evaluation of the patient’s response to the treatment.
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