Author Question: The nurse completes medication education with a client prescribed hydrochlorothiazide. The nurse ... (Read 62 times)

NguyenJ · **on:** Jul 23, 2018

The nurse completes medication education with a client prescribed hydrochlorothiazide . The nurse determines that teaching has been effective when the client makes which statement?

1. I take my medication early in the morning.
2. I really need to avoid grapefruit juice when I take this medication.
3. If I develop a cough, I should call my doctor.
4. I need to avoid salt substitutes and potassium-rich foods.

Question 2

A client with hypertension has experienced heart failure. The nurse notes that the client is receiving nifedipine (Procardia). Which is a priority assessment for the nurse?

1. Auscultate breath sounds for crackles.
2. Assess level of orientation.
3. Review recent lab results for hypokalemia.
4. Assess urinary output.

k2629 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale 1: Taking hydrochlorothiazide early in the day will help prevent nocturia.
Rationale 2: Grapefruit juice inhibits the metabolism of the calcium channel blockers.
Rationale 3: Development of a cough occurs with ACE inhibitors, not with diuretics.
Rationale 4: Hydrochlorothiazide is a potassium-excreting diuretic, and potassium supplementation is often necessary.
Global Rationale: Taking hydrochlorothiazide early in the day will help prevent nocturia. Grapefruit juice inhibits the metabolism of the calcium channel blockers. Development of a cough occurs with ACE inhibitors, not with diuretics. Hydrochlorothiazide is a potassium-excreting diuretic, and potassium supplementation is often necessary.

Answer to Question 2

Correct Answer: 1
Rationale 1: Some calcium channel blockers can reduce myocardial contractility and can worsen heart failure. Crackles in the lungs can indicate pulmonary edema, which could indicate heart failure.
Rationale 2: Level of orientation could be decreased with heart failure, but it is not a priority assessment at this time.
Rationale 3: Calcium channel blockers do not cause hypokalemia.
Rationale 4: Urinary output could be decreased with heart failure, but it is not a priority assessment at this time.
Global Rationale: Some calcium channel blockers can reduce myocardial contractility and can worsen heart failure. Crackles in the lungs can indicate pulmonary edema, which could indicate heart failure. Level of orientation could be decreased with heart failure, but it is not a priority assessment at this time. Calcium channel blockers do not cause hypokalemia. Urinary output could be decreased with heart failure, but it is not a priority assessment at this time.