Which of the following is most important for the nurse to include with calcium channel blockers?

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.

Choice A reason: This is correct because high lipid levels, such as cholesterol and triglycerides, are a risk factor for cardiovascular disease. HMG-CoA reductase inhibitors, also known as statins, lower the production of cholesterol in the liver and reduce the risk of heart attack and stroke.

Choice B reason: This is incorrect because blood glucose of 60 is not related to the need for an HMG-CoA reductase inhibitor. Blood glucose of 60 is below the normal range and may indicate hypoglycemia, which is a low blood sugar level. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and hunger.

Choice C reason: This is incorrect because platelets over 150,000 are not related to the need for an HMG-CoA reductase inhibitor. Platelets are blood cells that help with clotting and prevent bleeding. The normal range of platelets is 150,000 to 450,000 per microliter of blood. Platelets over 150,000 are within the normal range and do not indicate a problem.

Choice D reason: This is incorrect because low INR is not related to the need for an HMG-CoA reductase inhibitor. INR stands for international normalized ratio and is a measure of how long it takes the blood to clot. The normal range of INR is 0.8 to 1.2. Low INR means the blood clots faster than normal and may indicate a risk of thrombosis, which is a blood clot in a vein or artery.