How should the nurse instruct a patient with adrenal ...

[joblessjake]

How should the nurse instruct a patient with adrenal insufficiency to take glucocorticoid therapy? You may select more than one answer.
 
  a. Take the entire dose once at night.
  b. Take two thirds in the morning and one third in the evening.
  c. Divide the dose in half; take half in the morning and half in the afternoon.
  d. Take one third in the morning and two thirds in the afternoon.
  e. Doses should be taken every other day.

Question 2

A patient with increasing renal insufficiency and nephrosclerosis is admitted to the unit and is started on oral antihypertensive therapy. Given the patient's medical history, the nurse would question a prescription for
 
  a. propranolol (Inderal).
  b. methyldopa (Aldomet).
  c. hydralazine (Apresoline).
  d. spironolactone (Aldactone).

[kmb352]

Answer to Question 1

a, b

Answer to Question 2

D
Spironolactone should be avoided, because it is only a mild diuretic with dysfunctional kidneys.
Inderal, Aldomet and Apresoline all are antihypertensive agents and may be used. Although all classes of antihypertensive agents are effective in nephrosclerosis, angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) work best. As a rule, a diuretic also is used. In patients with advanced renal insufficiency, thiazide diuretics are ineffective; a loop diuretic should be used.

[joblessjake]

TYSM

[bigsis44]

Excellent