What information will the nurse include when teaching the patients about taking beta-blocking drugs for the treatment of angina?
"Call your healthcare provider if your heart rate is 64 beats/min.”.
"These drugs are safe to use in patients who have asthma.”.
"Call your healthcare provider if you experience a weight gain of 2 lb or more in 24 hours or 5 lb or more in 1 week.”.
"Avoid taking these medications with grapefruit juice.”.
The Correct Answer is C
Choice A rationale
A heart rate of 64 beats/min is within the normal range for an adult (60-100 beats/min) and is not a cause for concern. Patients taking beta-blockers often have a lower resting heart rate due to the medication's effect, and this value would typically be considered a therapeutic response.
Choice B rationale
Beta-blocking drugs are generally contraindicated in patients with asthma because they can cause bronchospasm by blocking beta-2 receptors in the lungs. This can worsen asthmatic symptoms and lead to respiratory distress, so these medications are not safe for this patient population.
Choice C rationale
A weight gain of 2 lb in 24 hours or 5 lb in 1 week may indicate fluid retention, a sign of worsening heart failure. Patients with angina may also have underlying heart failure, and beta-blockers can sometimes worsen this condition. It is important to monitor for signs of fluid overload.
Choice D rationale
Grapefruit juice is known to interact with certain medications by inhibiting the cytochrome P450 enzymes, leading to increased drug levels. However, it does not have a significant interaction with most beta-blocking drugs and therefore does not need to be avoided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Beta-blockers do not cause vasodilation of the coronary arteries. In some cases, non-selective beta-blockers may even cause unopposed alpha-1 receptor stimulation, leading to vasoconstriction. Their primary benefit post-MI is not related to vasodilation but to their effects on cardiac work.
Choice B rationale
Beta-blockers decrease the force of cardiac contraction (negative inotropic effect) rather than increasing it. This reduction in contractility, along with a decreased heart rate, reduces the heart's workload and oxygen demand, which is beneficial after a myocardial infarction.
Choice C rationale
Beta-blockers slow the heart rate (negative chronotropic effect) by blocking beta-1 receptors in the sinoatrial (SA) node. This action reduces myocardial oxygen demand, decreases the workload on the heart, and prolongs diastole, allowing for improved coronary artery filling. This is the main benefit for a post-MI patient.
Choice D rationale
While beta-blockers are used to treat hypertension and can help maintain blood pressure, the primary benefit for a post-MI patient is the reduction of myocardial oxygen demand by slowing the heart rate and decreasing contractility. This action helps to prevent further damage to the heart muscle.
Correct Answer is B
Explanation
Choice A rationale
Antithyroid drugs are used to treat hyperthyroidism, a condition characterized by excessive thyroid hormone production. Their primary mechanism is to decrease, not increase, the synthesis of thyroid hormones to bring the body's metabolic rate back to a normal range.
Choice B rationale
The primary action of antithyroid medications, such as methimazole and propylthiouracil, is to inhibit the synthesis of thyroid hormones within the thyroid gland. They achieve this by blocking key enzymatic steps involved in the production of triiodothyronine ($T_3$) and thyroxine ($T_4$).
Choice C rationale
Antithyroid drugs do not directly stimulate the release of thyroid-stimulating hormone (TSH). TSH is produced by the pituitary gland, and its release is primarily regulated by the hypothalamus's secretion of thyrotropin-releasing hormone (TRH) and a negative feedback loop from circulating thyroid hormones.
Choice D rationale
While some antithyroid treatments, like radioactive iodine, do destroy thyroid tissue, this is not the primary action of most antithyroid drugs such as methimazole and propylthiouracil. These drugs work by inhibiting hormone production, leaving the thyroid tissue itself intact.
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