A patient has heart failure and is taking an ACE inhibitor. The ...

[washai]

A patient has heart failure and is taking an ACE inhibitor. The patient has developed fibrotic changes in the heart and vessels. The nurse expects the provider to order which medication to counter this development?
 
  a. Aldosterone antagonist
  b. Angiotensin II receptor blocker (ARB)
  c. Beta blocker
  d. Direct renin inhibitor (DRI)

Question 2

Tadalafil Cialis was prescribed 4 weeks ago for a patient with erectile dysfunction. The patient also takes prazosin Minipress for hypertension. Which statement by the patient best demon-strates understanding of the use of tadalafil Cialis?
 
  a. I can take this up to 2 times a day, just before intercourse.
  b. I have a little renal trouble, so I should take a higher dose.
  c. I should take this medication with food.
  d. I should take this medication no more than once a day.

[vkodali]

Answer to Question 1

A
Aldosterone antagonists are added to therapy for patients with worsening symptoms of HF. Al-dosterone promotes myocardial remodeling and myocardial fibrosis, so aldosterone antagonists can help with this symptom. ARBs are given for patients who do not tolerate ACE inhibitors. Beta blockers do not prevent fibrotic changes. DRIs are not widely used.

Answer to Question 2

D
Tadalafil should be taken no more than once a day and without regard to meals. Tadalafil has a half-life of 17.5 hours and should not be taken twice a day. Men with moderate renal or hepatic insufficiency should take a reduced dosage. This patient may be confusing the actions of tadalafil and prazosin.

[washai]

Thank you!

[vkodali]

Always glad to help...