Author Question: A patient who was recently prescribed an adrenergic drug says, I am so nervous and I cannot sleep. ... (Read 43 times)

misspop · **on:** Jul 23, 2018

A patient who was recently prescribed an adrenergic drug says, I am so nervous and I cannot sleep. The nurse would ask which questions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

1. How much coffee do you drink?
2. Have you recently increased your intake of dairy products?
3. Do you eat chocolate?
4. When was the last time you ate pickled foods or aged cheese?
5. How much wine or other alcoholic beverages do you drink?

Question 2

For the last 3 months, the nurse has been working with a group of patients who have been using nonpharmacological methods to try to manage their hypertension. The nurse anticipates that which patients will require the addition of a pharmacological intervention?

1. A 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy.
2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes.
3. A 56-year-old woman whose blood pressure is 135/84 who also has Cushing's disease.
4. A 65-year-old man whose blood pressure is 148/88 mmHg who is otherwise healthy.
5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy.

missalyssa26 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

1,3
Rationale 1: The caffeine in coffee may cause excessive nervousness, insomnia, and tremors.
Rationale 2: There should be no drug-food interaction with dairy products.
Rationale 3: The caffeine in chocolate may cause excessive nervousness, insomnia, and tremors.
Rationale 4: There should be no drug-food interaction with pickled foods or aged cheese.
Rationale 5: There should be no drug-food interaction with beverages that contain alcohol.

Global Rationale: The caffeine in coffee or chocolate may cause excessive nervousness, insomnia, and tremors. There should be no drug-food interaction with dairy products, pickled foods, aged cheese, or beverages containing alcohol.

Answer to Question 2

2,5
Rationale 1: Hypertension in this age group of healthy adults is considered to be 140/90 mmHg.
Rationale 2: Since this 61-year-old has both hypertension and diabetes, pharmacotherapy is indicated.
Rationale 3: This patient's blood pressure is no longer in the range of hypertension.
Rationale 4: Since there are no other compelling illnesses, this patient's hypertension does not need pharmacological intervention.
Rationale 5: Blood pressure over 150/90 mmHg requires treatment in those over age 60.

Global Rationale: HTN is defined as blood pressure over 140/90 mmHg. Patients over age 60 who do not have chronic kidney disease or diabetes do not need pharmacotherapy until the 150/90 mmHg threshold has been reached.