What labs would indicate a client may need a prescription for an HMG-CoA reductase inhibitor, such as atorvastatin?

Choice A reason: Age is a non-modifiable risk factor for hypertension because the risk of high blood pressure increases as we get older. This is due to changes in the heart and blood vessels, such as loss of elasticity and stiffening of the arteries, that affect the blood flow and pressure. ¹

Choice B reason: Genetics is a non-modifiable risk factor for hypertension because some people inherit genes that make them more likely to develop high blood pressure. For example, people of African and Black Caribbean descent have a higher risk of hypertension due to genetic variations that affect salt sensitivity and blood vessel function. ²

Choice C reason: Smoking is a modifiable risk factor for hypertension because it can be changed or avoided by quitting tobacco use. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries that narrows them and raises blood pressure. Smoking also lowers the level of good cholesterol (HDL) and raises the level of bad cholesterol (LDL) and triglycerides, which are fats in the blood that contribute to plaque formation. ³

Choice D reason: Obesity is a modifiable risk factor for hypertension because it can be changed or prevented by losing weight or maintaining a healthy weight. Obesity increases the risk of high blood pressure by putting extra strain on the heart and blood vessels, as well as by causing hormonal and metabolic changes that affect blood pressure regulation. Obesity is also associated with other conditions that can raise blood pressure, such as diabetes, sleep apnea, and kidney disease. ⁴

Choice E reason: Sedentary lifestyle is a modifiable risk factor for hypertension because it can be changed or improved by increasing physical activity. Sedentary lifestyle increases the risk of high blood pressure by reducing the ability of the blood vessels to dilate and contract, as well as by increasing the risk of obesity, diabetes, and high cholesterol. Physical activity helps to lower blood pressure by improving blood flow, strengthening the heart muscle, and lowering body weight and stress levels. .

Choice A reason: This choice is incorrect because there is no need to recheck the heart rate in one hour before giving the digoxin. The client's apical heart rate is within the normal range (60 to 100 beats per minute) and does not indicate bradycardia (slow heart rate), which is a sign of digoxin toxicity. The nurse should check the apical heart rate for one full minute before giving the digoxin and withhold the dose if the heart rate is below 60 beats per minute.

Choice B reason: This choice is correct because the client's digoxin level is within the therapeutic range (0.5 to 2.0 ng/mL) and does not indicate digoxin toxicity or underdosing. The client's vital signs and labs are also stable and do not indicate any adverse effects of digoxin. Digoxin is a cardiac glycoside that improves the contractility and efficiency of the heart and helps to control the heart rate and rhythm in clients with heart failure. The nurse should give the digoxin as ordered and monitor the client's response and digoxin level.

Choice C reason: This choice is incorrect because there is no indication for a chest x-ray for this client. A chest x-ray is a diagnostic test that can show the size and shape of the heart and lungs and detect any abnormalities, such as fluid accumulation, infection, or tumors. The client's symptoms and labs do not suggest any pulmonary complications or worsening of heart failure that would require a chest x-ray. The nurse should follow the provider's orders and protocols for chest x-ray indications.

Choice D reason: This choice is incorrect because there is no reason to hold the digoxin and call the MD for this client. The client's digoxin level is not too high or too low and does not require dose adjustment or discontinuation. The client's vital signs and labs are also normal and do not indicate any signs of digoxin toxicity or adverse effects. Holding the digoxin could cause the client's heart failure to worsen or cause arrhythmias. The nurse should only hold the digoxin and call the MD if the client has signs of digoxin toxicity, such as nausea, vomiting, visual disturbances, confusion, or bradycardia. .