A patient who has been taking verapamil (Calan) for hypertension ...

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A patient who has been taking verapamil (Calan) for hypertension complains of constipation. The patient will begin taking amlodipine (Norvasc) to prevent this side effect.
 
  The nurse provides teaching about the difference between the two drugs. Which statement by the patient indicates that further teaching is needed?
  a. I can expect dizziness and facial flushing with nifedipine.
  b. I should notify the provider if I have swelling of my hands and feet.
  c. I will need to take a beta blocker to prevent reflex tachycardia.
  d. I will need to take this drug once a day.

Question 2

A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient?
 
  a. Decreased cardiac preload
  b. Decreased cardiac output
  c. Increased tissue perfusion
  d. Increased ventricular contraction

[mcni194]

Answer to Question 1

ANS: C
Amlodipine produces selective blockade of calcium channels in blood vessels with minimal effects on the heart. Reflex tachycardia is not common, so a beta blocker is not indicated to prevent this effect. Dizziness and facial flushing may occur. Peripheral edema may occur and should be reported to the provider. Amlodipine is given once daily.

Answer to Question 2

ANS: C
Vasodilators that dilate resistance vessels, or arterioles, cause a decrease in afterload, which allows cardiac output and tissue perfusion to increase. A decrease in preload would be the result of dilation of capacitance vessels, or veins. Dilation of arterioles increases cardiac output. Ventricular contraction results when preload is increased.

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