CH 22-sherpath- week 4
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Questions and Answers

The nurse is administering oral hydralazine at 0800 to a patient for hypertension. At which time would the nurse anticipate the onset of the drug?

  • 0810
  • 0830 (correct)
  • 0900
  • 0930
  • A continuous infusion of sodium nitroprusside has been stopped. Which effect on the patient’s blood pressure would the nurse anticipate?

  • Blood pressure will increase. (correct)
  • Blood pressure will decrease.
  • Blood pressure will remain the same.
  • Blood pressure will fluctuate.
  • Ms. Jones reports episodes of joint and muscle pain to the nurse. What would the nurse’s priority action be?

  • Call the health care provider and request a prescription for an antinuclear antibody (ANA) panel. (correct)
  • Call the health care provider for a prescription of pain medication.
  • Rate the pain and continue to assess.
  • Call the health care provider and request an order for an x-ray.
  • A patient has been on a sodium nitroprusside infusion for 6 days and starts talking about the color of the sky while pointing to the ceiling. What does the nurse suspect?

    <p>Thiocyanate toxicity</p> Signup and view all the answers

    The nurse is teaching a patient who is being discharged on hydralazine. Which patient statement indicates understanding?

    <p>“If I keep smoking, I will continue to have pain from vasospasm.”</p> Signup and view all the answers

    The nurse is explaining to a patient the way that hydralazine lowers blood pressure. Which nursing statement is appropriate?

    <p>“Hydralazine lowers peripheral vascular resistance, which lowers blood pressure.”</p> Signup and view all the answers

    The nurse is reviewing the medication list for a patient admitted with a hypertensive emergency. Which drug would the nurse anticipate for administration that produces both venous and arteriolar dilation?

    <p>Sodium nitroprusside</p> Signup and view all the answers

    The nurse is administering a prescribed dose of sodium nitroprusside to a patient at 2100 hours. At what time will the nurse anticipate the peak effect of the drug?

    <p>2102</p> Signup and view all the answers

    The nurse is reviewing absorption of vasodilators. Which nursing statement is appropriate?

    <p>Minoxidil is absorbed well with oral administration.</p> Signup and view all the answers

    A patient who has been admitted for a hypertensive crisis is prescribed hydralazine. Which nursing intervention is the priority?

    <p>Place a fall-risk armband on the patient.</p> Signup and view all the answers

    For which patients does the nurse recognize a contraindication for vasodilators?

    <p>A 36-year-old patient with a blood pressure of 88/40 mm Hg</p> Signup and view all the answers

    A patient experiencing hypertensive crisis has been receiving intravenous sodium nitroprusside for the past 5 days. The patient is restless and is no longer able to answer common questions. Which nursing intervention is appropriate?

    <p>Stop administration of sodium nitroprusside.</p> Signup and view all the answers

    At a follow-up appointment, a patient who is taking hydralazine for hypertension reports feeling lightheaded and dizzy when standing up. What teaching will the nurse provide?

    <p>“Sit on the edge of the chair and stand up slowly.”</p> Signup and view all the answers

    Which assessment finding would the nurse report as a complication related to volume expansion in a patient who is prescribed vasodilator therapy?

    <p>Fine rales on lung auscultation</p> Signup and view all the answers

    Place the steps of the renin-angiotensin-aldosterone system (RAAS) in order.

    <p>Renin forms angiotensin I. = 1 Angiotensin-converting enzyme converts angiotensin I to angiotensin II. = 2 Angiotensin II, a potent vasoconstrictor, triggers the adrenal cortex to secrete aldosterone. = 3 Aldosterone enhances excretion of potassium and resorption of sodium and water in the kidneys, increasing blood volume. = 4</p> Signup and view all the answers

    The nurse is teaching a course on the mechanism of action of angiotensin-converting enzyme (ACE) inhibitors. Which teaching will the nurse include?

    <p>ACE inhibitors suppress conversion of angiotensin I to angiotensin II</p> Signup and view all the answers

    The nurse is administering valsartan to a patient with hypertension at 0800. Based on the onset of the drug, at which time will the nurse anticipate an effect on the patient’s blood pressure?

    <p>1000</p> Signup and view all the answers

    Which nursing action is the priority when administering lisinopril to Mr. Lowe for the first time?

    <p>Monitoring for marked hypotension</p> Signup and view all the answers

    Before starting the lisinopril for Mr. Lowe, which assessment data requires nursing intervention first?

    <p>Mr. Lowe takes ibuprofen daily for arthritis.</p> Signup and view all the answers

    The nurse is preparing to administer captopril to a patient. Which patient action would cause the nurse to hold the medication?

    <p>The patient is eating breakfast.</p> Signup and view all the answers

    A 25-year-old female patient is being discharged from the hospital on valsartan after a hypertensive crisis. Which information would the nurse include in the discharge teaching? Select all that apply.

    <p>“Use contraceptives while taking valsartan.”</p> Signup and view all the answers

    The nurse is teaching a class on angiotensin receptor blockers (ARBs). What would the nurse include in the teaching?

    <p>ARBs lower blood pressure by preventing vasoconstriction. ARBs are generally well absorbed.</p> Signup and view all the answers

    The nurse administered a dose of lisinopril at 0800, and the patient’s blood pressure was 189/96 mm Hg. Based on the pharmacodynamics of the drug, at which time would the nurse anticipate the greatest reduction in blood pressure?

    <p>1400</p> Signup and view all the answers

    A patient who is prescribed lisinopril asks the nurse, “Will this drug help the swelling in my legs?” Which nursing response is appropriate?

    <p>“Lisinopril may help the edema from progressing, as this drug suppresses aldosterone, which promotes sodium and water excretion.”</p> Signup and view all the answers

    The nurse is completing discharge teaching, which includes the direction, “Do not stop the angiotensin-converting enzyme (ACE) inhibitor abruptly.” Which effect would the nurse tell the patient to expect if the medication were stopped suddenly?

    <p>Dramatic increase in blood pressure</p> Signup and view all the answers

    For which patients is the use of an angiotensin-converting enzyme (ACE) inhibitor contraindicated?

    <p>32-year-old female patient who is 4 months pregnant</p> Signup and view all the answers

    The nurse is providing education to a patient who is being discharged on valsartan. Which patient responses indicate that more education is required?

    <p>&quot;Which one of those medications is for my blood pressure?&quot;</p> Signup and view all the answers

    A patient who is hospitalized following a planned orthopedic surgery has been taking a routine dose of lisinopril since the operative day. Which action will the nurse take when a sudden onset of facial swelling is noted?

    <p>Prepare to administer epinephrine subcutaneously.</p> Signup and view all the answers

    A patient who is taking metoprolol questions the nurse regarding the need for liver function tests. Which nursing response is appropriate?

    <p>“Patients with decreased liver function may experience toxic effects from this drug.”</p> Signup and view all the answers

    The nurse administers an oral dose of metoprolol at 0800 to a patient with hypertension. At which time will the nurse anticipate the peak effect?

    <p>1000</p> Signup and view all the answers

    The charge nurse is teaching a group of new nurses about safe administration of beta blockers. Which statements indicate that further teaching is required? Select all that apply.

    <p>“Beta blockers increase the heart rate and force of cardiac contraction.”</p> Signup and view all the answers

    The nurse is teaching Ms. Jones about her new prescription for metoprolol. What teachings will the nurse include?

    <p>“Sit on the side of the bed for a few moments prior to standing up.”</p> Signup and view all the answers

    The nurse is conducting a health history on a patient who is taking a beta blocker. Which assessment data present contraindications or cautions to beta blocker therapy? Select all that apply

    <p>History of asthma</p> Signup and view all the answers

    The health care provider prescribes a maintenance dose of metoprolol 250 mg orally twice daily for hypertension. Which action would the nurse take upon receiving the prescription?

    <p>Hold the medication and ask the health care provider about the dose.</p> Signup and view all the answers

    The charge nurse is teaching a new nurse about beta blockers. Which teaching would the nurse include?

    <p>First-generation beta blockers are nonselective and block beta1 and beta2 receptors.</p> Signup and view all the answers

    A patient is admitted to the emergency department with a blood pressure of 222/110 mm Hg. For which reason would the nurse anticipate intravenous (IV) beta blocker administration?

    <p>IV forms of beta blockers have immediate effects.</p> Signup and view all the answers

    A 30-year-old female patient who is taking a beta blocker asks the nurse, “Can I take this drug if I am considering pregnancy?” Which nursing response is appropriate?

    <p>“There is potential risk to the fetus because metoprolol crosses the placental barrier.”</p> Signup and view all the answers

    A patient who has hypertension and asthma asks, “Why can’t I take a beta blocker for my hypertension?” Which nursing response is appropriate?

    <p>“Beta blocker medications can cause bronchospasm, which can trigger an asthma attack.”</p> Signup and view all the answers

    The nurse is caring for a patient with newly diagnosed hypertension who has been prescribed metoprolol. Which teaching would the nurse include?

    <p>Change positions slowly.</p> Signup and view all the answers

    The nurse is teaching a patient who is being discharged with a prescription for metoprolol. Which patient statement indicates understanding of the teaching?

    <p>“I will not drive until I know how this medication affects me.”</p> Signup and view all the answers

    A patient has been taking metoprolol IR for 6 weeks. Current assessment data includes a heart rate of 72 beats per minute and blood pressure of 126/74 mm Hg. The patient reports occasional dizziness, insomnia, and fatigue. Which recommendation will the nurse provide for this patient?

    <p>“It is important to discuss these symptoms with the health care provider.”</p> Signup and view all the answers

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