The nurse is caring for a 70-year-old patient who has recently ...

[Yolanda]

The nurse is caring for a 70-year-old patient who has recently begun taking amlodipine (Norvasc) 5 mg/day to control hypertension.
 
  The nurse notes mild edema of the patient's ankles, a blood pressure of 130/70 mm Hg, and a heart rate of 80 beats per minute. The patient reports flushing and dizziness. The nurse will notify the provider and
  a. ask to decrease the dose to 2.5 mg/day.
  b. discuss twice daily dosing.
  c. request an order for a diuretic.
  d. suggest adding propranolol to the regimen.

Question 2

The nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor to a patient who has hypertension. The nurse notes peripheral edema and swelling of the patient's lips.
 
  The patient has a blood pressure of 160/80 mm Hg and a heart rate of 76 beats per minute. What is the nurse's next action?
  a. Administer the dose and observe carefully for hypotension.
  b. Hold the dose and notify the provider of a hypersensitivity reaction.
  c. Notify the provider and request an order for a diuretic medication.
  d. Request an order for serum electrolytes and renal function tests.

[LP]

Answer to Question 1

ANS: A
This patient is experiencing side effects of the medication. Elderly patients often require lower doses, so the nurse should ask about a dose reduction. Older adults generally require 2.5 to 5.0 mg/day. Twice daily dosing is not recommended. Unless edema persists, a diuretic is not indicated.

Answer to Question 2

ANS: B
The patient has signs of angioedema which indicates a hypersensitivity reaction. The nurse should hold the dose and notify the provider. Giving the dose will make the reaction more serious. These are not signs of edema, so a diuretic is not indicated. Electrolytes and renal function tests are not indicated.

[Yolanda]

Excellent

[anyusername12131]

TYSM