The charge nurse observes a new registered nurse (RN) doing ...

[ereecah]

The charge nurse observes a new registered nurse (RN) doing discharge teaching for a patient with hypertension who has a new prescription for enalapril (Vasotec). The charge nurse will need to intervene if the new RN tells the patient to
 
  a. increase the dietary intake of high-potassium foods.
  b. make an appointment with the dietitian for teaching.
  c. check the blood pressure (BP) with a home BP monitor at least once a day.
  d. move slowly when moving from lying to sitting to standing.

Question 2

The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside (Nipride). Which nursing action can the nurse delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
 
  a. Titrate nitroprusside to decrease mean arterial pressure (MAP) to 115 mm Hg.
  b. Evaluate effectiveness of nitroprusside therapy on blood pressure (BP).
  c. Set up the automatic blood pressure machine to take BP every 15 minutes.
  d. Assess the patient's environment for adverse stimuli that might increase BP.

[Tonyam972]

Answer to Question 1

ANS: A
The ACE inhibitors cause retention of potassium by the kidney, so hyperkalemia is a possible adverse effect. The other teaching by the new RN is appropriate for a patient with newly diagnosed hypertension who has just started therapy with enalapril.

Answer to Question 2

ANS: C
LPN/LVN education and scope of practice include the correct use of common equipment such as automatic blood pressure machines. The other actions require advanced nursing judgment and education, and should be done by RNs.