Ivy Tech, Pharmocology
Ivy Tech, Pharmocology ( 41 Questions)
The nurse is preparing medications for a client with a history of hypertension that is post-op day 3 following hip replacement.
Meds: Atenolol 25 mg PO, Captopril 10 mg PO, Glipizide 5 mg PO, Atorvastatin 20 mg PO, and Enoxaparin 40 mg SQ.
Vital signs: blood pressure 138/90, heart rate 82, respiratory rate 18, temperature 99.7, O2 saturation 96% on room air.
Today's labs: sodium- 143 meq/L, potassium 6.2 mmol/L, hemoglobin 11.1 gm/dL, platelets 104,000, white blood count 10.8, blood glucose 130.
How should the nurse proceed with the medication administration?
This statement is false. The nurse should not hold glipizide, as it is an oral antidiabetic drug that lowers blood glucose by stimulating the release of insulin from the pancreas. The client has a normal blood glucose level, which can be maintained by taking the glipizide as ordered. The nurse should also encourage the client to follow a balanced diet and exercise regimen.
This statement is true. The nurse should check the apical heart rate prior to captopril, as it is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents kidney damage. However, it can also cause bradycardia, which is a slow heart rate. The nurse should hold the captopril and notify the prescriber if the heart rate is below 60 beats per minute.
This statement is false. The nurse should not give atenolol as ordered, as it is a beta-blocker that lowers blood pressure and heart rate. It can also prevent angina and reduce the risk of heart attack. The client has a slightly elevated blood pressure and a normal heart rate, which can be expected after surgery. The nurse should monitor the client's vital signs and adjust the dose accordingly.
This statement is false. The nurse should not call the prescriber and ask to change atorvastatin to gemfibrozil, as they are both lipid-lowering drugs that reduce cholesterol and triglycerides. However, they have different mechanisms of action and side effects. Atorvastatin is a statin that inhibits the enzyme that produces cholesterol in the liver. Gemfibrozil is a fibrate that activates the enzyme that breaks down triglycerides in the blood. The nurse should administer the atorvastatin as ordered and monitor the client's liver function and lipid profile.
Choice A reason: This statement is false. The nurse should not hold glipizide, as it is an oral antidiabetic drug that lowers blood glucose by stimulating the release of insulin from the pancreas. The client has a normal blood glucose level, which can be maintained by taking the glipizide as ordered. The nurse should also encourage the client to follow a balanced diet and exercise regimen.
Choice B reason: This statement is true. The nurse should check the apical heart rate prior to captopril, as it is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents kidney damage. However, it can also cause bradycardia, which is a slow heart rate. The nurse should hold the captopril and notify the prescriber if the heart rate is below 60 beats per minute.
Choice C reason: This statement is false. The nurse should not give atenolol as ordered, as it is a beta-blocker that lowers blood pressure and heart rate. It can also prevent angina and reduce the risk of heart attack. The client has a slightly elevated blood pressure and a normal heart rate, which can be expected after surgery. The nurse should monitor the client's vital signs and adjust the dose accordingly.
Choice D reason: This statement is false. The nurse should not call the prescriber and ask to change atorvastatin to gemfibrozil, as they are both lipid-lowering drugs that reduce cholesterol and triglycerides. However, they have different mechanisms of action and side effects. Atorvastatin is a statin that inhibits the enzyme that produces cholesterol in the liver. Gemfibrozil is a fibrate that activates the enzyme that breaks down triglycerides in the blood. The nurse should administer the atorvastatin as ordered and monitor the client's liver function and lipid profile.