The nurse would recognize which of the following as non-modifiable risk factors for hypertension? SELECT ALL THAT APPLY

Choice A reason: This is incorrect because fentanyl 25 mcg/hr transdermal patch is a common and appropriate dose for chronic pain management. Fentanyl is a potent opioid analgesic that delivers a steady amount of medication through the skin over 72 hours.

Choice B reason: This is incorrect because meloxicam 15 mg PO daily is a standard and safe dose for treating inflammation and pain caused by arthritis. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that reduces the production of prostaglandins, which are involved in inflammation.

Choice C reason: This is correct because regular insulin 8 units subcutaneous before meals is a vague and potentially dangerous prescription. Regular insulin is a short-acting insulin that lowers blood glucose levels by facilitating the uptake of glucose into the cells. The dose of insulin should be individualized based on the client's blood glucose level, carbohydrate intake, and activity level. The nurse should contact the provider for clarification on how to adjust the dose according to the client's needs.

Choice D reason: This is incorrect because docusate sodium 200 mg PO at bedtime is a usual and effective dose for preventing constipation. Docusate sodium is a stool softener that works by increasing the amount of water in the stool, making it easier to pass.

Choice A reason: This choice is incorrect because checking the apical heart rate before taking calcium channel blockers is not necessary for most patients. Calcium channel blockers are a group of medications that relax and widen blood vessels, lower blood pressure, and slow the heart rate. They are used to treat conditions such as hypertension, angina, and arrhythmias. The nurse should check the apical heart rate only if the patient has a history of bradycardia (slow heart rate) or heart block (a problem with the electrical conduction of the heart).

Choice B reason: This choice is incorrect because calcium channel blockers do not cause increased blood pressure, but rather lower it. Blurred vision is not a common side effect of calcium channel blockers, and it may indicate other problems, such as eye infection, glaucoma, or stroke. The nurse should instruct the patient to report any changes in vision, but not to associate them with calcium channel blockers.

Choice C reason: This choice is incorrect because calcium channel blockers do not affect cholesterol levels, and the time of day they are taken does not matter. Cholesterol is a type of fat that circulates in the blood and can build up in the arteries, causing atherosclerosis (hardening and narrowing of the arteries). Cholesterol levels are influenced by diet, exercise, genetics, and other medications, such as statins. The nurse should advise the patient to follow a healthy lifestyle and take any prescribed medications for cholesterol control.

Choice D reason: This choice is correct because grapefruit juice can interact with some calcium channel blockers, such as nifedipine, verapamil, and diltiazem, and increase their blood levels and effects. This can cause serious side effects, such as low blood pressure, dizziness, headache, flushing, and edema (swelling). The nurse should warn the patient to avoid grapefruit juice and any products that contain grapefruit while taking calcium channel blockers.