A nurse counsels an elderly patient who is just beginning ...

[2125004343]

A nurse counsels an elderly patient who is just beginning verapamil (Calan) therapy. The nurse should include which pertinent and important side effect in the patient's education?
 
  a. Diarrhea is common and can be treated with antacids.
  b. Photophobia occurs in many patients and can be minimized by wearing sunglasses and sunblock.
  c. Migraine headache is common and is relieved by reducing the dose.
  d. Dizziness may occur, therefore caution must be used when walking or rising from a sitting position.

Question 2

A patient is being treated for bilateral adrenal hyperplasia with an aldosterone antagonist. The nurse should prepare to administer ___________. The nurse understands that the rationale for this treatment is to _________________.
 
  a. spironolactone (Aldactone); increase the sodium level
  b. hydrocortisone; increase the blood glucose level
  c. spironolactone (Aldactone); help stabilize the potassium level
  d. fludrocortisone (Florinef); reduce the serum sodium level

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Answer to Question 1

D
Dizziness is a common side effect of verapamil, therefore the patient should use caution when rising to reduce the risk of falls.
Diarrhea is an uncommon side effect of verapamil. Constipation is the most common side effect of verapamil, especially in elderly patients.
Verapamil does not cause photophobia or migraine headaches.

Answer to Question 2

C
When bilateral adrenal hyperplasia is the cause of hyperaldosteronism, an aldosterone antagonist is the preferred treatment. Spironolactone is used most often, because it normalizes the potassium level within 2 weeks.
Spironolactone is used to treat bilateral adrenal hyperplasia; however, it normalizes the potassium level rather than increasing the sodium level.
Hydrocortisone is not indicated for the treatment of bilateral adrenal hyperplasia.
Fludrocortisone is indicated for the treatment of Addison's disease, primary hypoaldosteronism, and congenital adrenal hyperplasia. The sodium level should increase with this drug.

[2125004343]

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