Client Teaching on Medication Management

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Questions and Answers

What should clients avoid while being treated with calcium channel blocking agents?

Engaging in regular physical activity

Eating high-sodium foods

Over-the-counter drugs (correct)

Taking medications on an empty stomach

What is an important consideration before administering calcium channel blocking agents?

Taking pulse or blood pressure beforehand (correct)

Administering with food to enhance absorption

Adjusting the dosage based on weight only

Limiting fluid intake before medication

Which statement reflects proper client education regarding medication adherence for hypertension?

Adjust medication dosage based on physical activity

Discontinue medication if you feel well

Take medication only as directed, even when feeling well (correct)

Take medication only when symptoms arise

What adverse effect should clients be educated about when taking calcium channel blocking agents?

Precipitous hypotension Signup and view all the answers

What lifestyle changes can enhance the effectiveness of hypertension therapy?

Weight loss and smoking cessation Signup and view all the answers

Which of the following is NOT a typical adverse effect of calcium channel blocking agents?

Hyperkalemia Signup and view all the answers

What potential interaction should clients be aware of when taking diltiazem?

Potentiated hypotensive effect with cyclosporine Signup and view all the answers

Which of the following is a life-threatening adverse effect of calcium channel blocking agents?

Reflex tachycardia Signup and view all the answers

What is the primary action of angiotensin II receptor blockers?

They block vasoconstriction and aldosterone release. Signup and view all the answers

Which of the following is a common adverse effect of calcium channel blockers?

Precipitous hypotension Signup and view all the answers

What is the recommended client teaching regarding potassium for patients on angiotensin II receptor blockers?

Avoid salt substitutes containing potassium. Signup and view all the answers

Which condition is NOT a contraindication for calcium channel blockers?

Hypertension Signup and view all the answers

Which medication is an example of an angiotensin II receptor blocker?

Iosartan Signup and view all the answers

What is a common effect of anticholinergic agents that may also appear in patients taking calcium channel blockers?

Blurred vision Signup and view all the answers

How should diltiazem be administered to achieve desired effects in daily management?

30-120 mg by mouth 3-4 times daily. Signup and view all the answers

What nursing care consideration is important for patients taking angiotensin II receptor blockers?

Note drug-drug interactions. Signup and view all the answers

What is the main extracellular cation that regulates fluid volume and acid-base balance?

Sodium Signup and view all the answers

What is the normal serum potassium level range?

3.5 - 5 mEq/L Signup and view all the answers

Which of the following symptoms is specifically associated with hypokalemia?

Skeletal muscle weakness Signup and view all the answers

What is an effective intervention for a patient with severe hyperkalemia?

IV calcium gluconate Signup and view all the answers

What role does magnesium play in the body?

ATP production Signup and view all the answers

Which electrolyte imbalance can lead to decreased neuromuscular activity and generalized weakness?

Hypermagnesemia Signup and view all the answers

Which electrolyte is primarily regulated by the sodium-potassium pump?

Potassium Signup and view all the answers

Which is a common cause of hypokalemia?

Thiazide diuretics use Signup and view all the answers

What intervention is appropriate for managing mild hypomagnesemia?

Increased dietary magnesium Signup and view all the answers

What clinical sign is indicative of high levels of potassium in a patient's blood?

Paresthesia Signup and view all the answers

A patient shows signs of agitation, weakness, and tachycardia. What electrolyte imbalance could this indicate?

Hypochloremia Signup and view all the answers

What is a critical function of the sodium-potassium pump in muscle cells?

Prevents cell swelling Signup and view all the answers

What major role does sodium play in the body’s physiology?

Transmission of nerve impulses Signup and view all the answers

What is the end result of severe hypokalemia if left untreated?

Cardiac arrest Signup and view all the answers

Study Notes

Client Teaching Guidelines

Avoid over-the-counter drugs when on prescribed medications.
Change positions slowly to prevent orthostatic hypotension.
Measure pulse or blood pressure before medication administration.
Adhere strictly to medication regimens, even if symptoms improve, indicating effective therapy.
Combine therapy with lifestyle changes: weight loss, smoking cessation, and increased physical activity for optimal results.

Calcium Channel Blocking Agents

Action: Block calcium movement into muscle cells, reducing muscle contraction.
Examples:
- Amlodipine (Norvasc) 5-10 mg daily.
- Diltiazem (Cardizem) 30-120 mg 3-4 times daily; (Cardizem SR) 180-240 mg daily.
- Verapamil (Calan XR) 120-240 mg daily; IV 5-10 mg/kg, repeat 10 mg in 15-30 min if necessary.
Uses: Manage hypertension, angina, and dysrhythmias.
Adverse Effects:
- Severe: Orthostatic hypotension, reflex tachycardia, bradycardia, hypotension, heart block, heart failure.
- Other: Dizziness, weakness, sexual dysfunction, gastrointestinal issues.
Significant Cations and Anions:
- Major cations: Sodium (Na+), Potassium (K+), Calcium (Ca++), Magnesium (Mg++).
- Major anions: Chloride (Cl-), Bicarbonate (HCO3-), Phosphate (PO4-), Sulfate (SO4-).

Sodium and Water Balance

Sodium is the major extracellular cation, crucial for fluid balance and acid-base regulation; normal levels: 135 - 145 mEq/L.
Increased sodium raises extracellular fluid, activating thirst and ADH for water retention.
Sodium-potassium pump maintains cellular homeostasis and electrical charge for nerve impulses.

Hyponatremia and Hypernatremia

Hyponatremia:
- Defined as serum sodium < 135 mEq/L.
- Types: Dilutional, depletional, hypovolemic, hypervolemic, and isovolemic.
- Symptoms: Neurologic changes, muscle cramps, confusion, seizures, hypotension.
- Interventions: Fluid restriction for hyper/isovolemic; IV fluids or Na+ intake for hypovolemic cases. Severe cases may require hypertonic NaCl solutions.
Hypernatremia:
- Defined as serum sodium > 145 mEq/L.
- Symptoms: Skin flushing, agitation, thirst, neurological distress.
- Interventions: Gradual fluid replacement, monitor for cerebral edema, and implement seizure precautions.

Potassium Regulation

Major intracellular cation with normal levels of 3.5 - 5 mEq/L.
Controlled by dietary intake, renal regulation, and the sodium-potassium pump; influences neuromuscular and cardiac function.

Hypokalemia and Hyperkalemia

Hypokalemia:
- Serum potassium < 3.5 mEq/L, caused by GI losses or diuretics.
- Symptoms: Muscle weakness, constipation, EKG changes.
- Interventions: Increase dietary potassium, OR supplementation and IV replacement.
Hyperkalemia:
- Serum potassium > 5 mEq/L, often due to renal dysfunction or certain medications.
- Symptoms: Muscle weakness, EKG abnormalities, hypotension.
- Interventions: Mild - Loop diuretics; Moderate - Kayexalate; Severe - Calcium gluconate, Sodium bicarbonate, and emergency measures for critical cases.

Calcium and Magnesium Roles

Calcium: 99% in bones, supports cellular functions, cardiac contraction, and blood clotting.
- Hypocalcemia (< 8.9 mg/dL) symptoms include neuromuscular excitability; treat with calcium gluconate.
- Hypercalcemia (> 10.1 mg/dL) symptoms range from fatigue to cardiac arrest; hydration and diuretics may be used.
Magnesium: Supports ATP production and cardiovascular function.
- Hypomagnesemia (< 1.5 mEq/L) leads to CNS and neuromuscular symptoms; treatment includes dietary and IV supplementation.
- Hypermagnesemia (> 2.5 mEq/L) commonly caused by renal dysfunction; management focuses on hydration and possible hemodialysis.

Phosphorus and Chloride Overview

Phosphorus: Critical for cellular function and bone health; hypophosphatemia < 2.5 mg/dL leads to muscle weakness and confusion, treated with dietary changes or IV supplementation.
Chloride: Major extracellular anion; hypochloremia is < 96 mEq/L, while hyperchloremia > 106 mEq/L may indicate acid-base disturbances and requires correction of underlying issues.

Acid-Base Balance

pH measures hydrogen ion concentration (normal range: 7.35 - 7.45).
Acidosis: pH < 7.35, caused by acid accumulation; Alkalosis: pH > 7.45, related to base accumulation.
Regulatory systems: Chemical buffers, respiratory mechanisms, and renal adjustments work to stabilize pH levels.
Arterial Blood Gases (ABG) results – used to evaluate acid-base status through pH, PaCO2, and HCO3 levels.

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Description

This quiz covers essential client teaching points regarding medication management, including the safe use of over-the-counter drugs and the importance of monitoring vital signs. It emphasizes adherence to prescribed medication protocols and lifestyle changes for effective therapy.