A patient who has congestive heart failure and arthritis has been ...

[misspop]

A patient who has congestive heart failure and arthritis has been taking chlorthalidone (Zaroxolyn) 25 mg daily for 6 months. The primary care NP notes a persistent blood pressure of 145/90 mm Hg. The NP should:
 
  a. ask the patient which medications are used for pain.
  b. add furosemide (Lasix) to the patient's drug regimen.
  c. increase the dose of chlorthalidone to 100 mg daily.
  d. recommend that the patient use salt substitutes to season foods.

Question 2

A woman who uses a transdermal contraceptive calls the primary care NP to report that while dressing that morning she discovered that the patch had come off and she was unable to find the patch. The NP should tell her to apply a new patch and:
 
  a. take one cycle of COCPs.
  b. take a home pregnancy test.
  c. use condoms for the next 7 days.
  d. contact the clinic if she misses a period.

[katheyjon]

Answer to Question 1

A
For diuretic resistance, the NP should evaluate factors such as patient nonadherence, physiologic causes, and drugs that may increase resistance, including nonsteroidal antiinflammatory drugs (NSAIDs). This patient has arthritis, and it is likely that NSAID use may be causing diuretic resistance. A second drug, such as furosemide, should be added after the cause of diuretic resistance is determined. The maximum daily dose of chlorthalidone is 100 mg per day, but increasing the dose is not recommended to treat diuretic resistance. Recommending salt substitutes is not indicated.

Answer to Question 2

C
If a transdermal patch has been discovered to be loose or has come off, patients should use a backup method of contraception. It is not necessary to use oral contraceptives. A home pregnancy test is not indicated.

[misspop]

Thanks

[katheyjon]

Welcome