Author Question: A client is prescribed verapamil to treat hypertension and chronic stable angina. Which assessment ... (Read 32 times)

D2AR0N · **on:** Jul 23, 2018

A client is prescribed verapamil to treat hypertension and chronic stable angina. Which assessment finding is of greatest concern relative to potential adverse effects of amlodipine for this client?

1. Facial flushing
2. Respiratory rate 22 breaths per minute
3. Pedal edema 1+
4. Heart rate 132 beats per minute

Question 2

The nurse observes that a client admitted for orthopedic surgery also has a diagnosis of atrial fibrillation. Which drug can achieve a therapeutic effect relative to the client's diagnosis of atrial fibrillation?

1. Isradipine (DynaCirc)
2. Nifedipine (Procardia)
3. Nicardipine (Cardene)
4. Diltiazem (Cardizem)

coyin · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: Although it is a common adverse effect associated with peripheral vasodilation, facial flushing does not pose a serious risk to this client.
Rationale 2: This finding represents a normal respiratory rate.
Rationale 3: Although peripheral edema is an adverse effect associated with verapamil, minimal edema does not represent a more significant risk than another condition.
Rationale 4: This finding represents reflex tachycardia, a potential adverse effect of verapamil. Reflex tachycardia can lead to myocardial ischemia by increasing cardiac workload in a client with chronic stable angina.
Global Rationale: Heart rate 132 beats per minute represents reflex tachycardia, a potential adverse effect of verapamil. Reflex tachycardia can lead to myocardial ischemia by increasing cardiac workload in a client with chronic stable angina. Facial flushing is a common adverse effect associated with peripheral vasodilation, facial flushing does not pose a serious risk to this client. Respiratory rate 22 breaths per minute represents a normal respiratory rate. Although peripheral edema is an adverse effect associated with verapamil, minimal edema does not represent a more significant risk than another condition.

Answer to Question 2

Correct Answer: 4
Rationale 1: Isradipine is a dihydropyridine drug approved only for treatment of hypertension.
Rationale 2: Nifedipine is a dihydropyridine drug, and does not slow cardiac conduction.
Rationale 3: Nicardipine is a dihydropyridine drug with no effect on conduction within the myocardium.
Rationale 4: Diltiazem is a nondihydropyridine drug used to manage atrial fibrillation because it slows conduction through the SA node.
Global Rationale: Diltiazem is a nondihydropyridine drug used to manage atrial fibrillation because it slows conduction through the SA node. Isradipine is a dihydropyridine drug approved only for treatment of hypertension. Nifedipine is a dihydropyridine drug, and does not slow cardiac conduction. Nicardipine is a dihydropyridine drug with no effect on conduction within the myocardium.