Author Question: A patient with chronic hypertension is admitted to the hospital. During the admission assessment, ... (Read 53 times)

Mollykgkg · **on:** Jul 23, 2018

A patient with chronic hypertension is admitted to the hospital.

During the admission assessment, the nurse notes a heart rate of 96 beats per minute, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will con-tact the provider to request an order for which medication? a. ACE inhibitor
b. Digoxin Lanoxin
c. Furosemide Lasix
d. Spironolactone Aldactone

Question 2

A nurse is teaching a patient about the use of sildenafil Viagra for erectile dysfunction. Which statement by the patient indicates understanding of the teaching?

a. If my erection lasts longer than 4 hours, I should contact my provider.
b. I should not use nitroglycerin within 12 hours of using sildenafil.
c. I should take this drug about 15 minutes before sexual activity.
d. This drug may cause me to have an erec-tion when I don't want one.

scottmt · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

C
This patient shows signs of fluid volume overload and needs a diuretic. Furosemide is a loop di-uretic, which can produce profound diuresis very quickly even when the glomerular filtration rate (GFR) is low. An ACE inhibitor will not reduce fluid volume overload. Digoxin has a positive inotropic effect on the heart, which may improve renal perfusion, but this is not its primary effect. Spironolactone is a potassium-sparing diuretic with weak diuresis effects; it is used in conjunction with other diuretics to improve electrolyte balance.

Answer to Question 2

A
Priapism can occur and can cause tissue damage to the penis, so an erection lasting longer than 4 hours should be reported. Patients who use nitroglycerin should not use sildenafil within 24 hours of taking this drug. Patients should be advised to take sildenafil 30 minutes to 4 hours before anticipated sexual activity. Sildenafil does not cause an erection without sexual stimuli.