A client diagnosed with hyperlipidemia has been taking atorvastatin for several months. How can the therapeutic effect of the medication be determined?
assessing the client's resting heart rate and postural blood pressures
reviewing the client's laboratory blood work results
assessing the client's exercise tolerance and activities of daily living
performing a focused cardiac assessment
The Correct Answer is B
A. While resting heart rate and blood pressure are important for overall cardiovascular health, they do not specifically assess the effectiveness of atorvastatin in lowering lipid levels.
B. Reviewing laboratory blood work results, particularly lipid panels, is essential to determine the therapeutic effect of atorvastatin, as it directly measures changes in cholesterol levels (such as LDL and total cholesterol).
C. Assessing exercise tolerance and activities of daily living can provide insight into overall health and well-being but does not specifically evaluate the impact of atorvastatin on lipid levels.
D. A focused cardiac assessment is beneficial for understanding cardiovascular health but is not specific for measuring the effectiveness of lipid-lowering therapy with atorvastatin.
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Correct Answer is D
Explanation
A. Giving the drug with food may delay absorption but does not affect the extent of the first-pass effect.
B. Administering the drug in small, frequent doses may help maintain therapeutic levels but will not significantly alter the first-pass effect.
C. Limiting protein intake could reduce drug binding to proteins, but this is not a standard approach for managing first-pass metabolism.
D. Administering the drug intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect, thereby increasing the amount of free drug available to body cells.
Correct Answer is A
Explanation
A. The combination of nitroglycerin and sildenafil can lead to severe hypotension due to the vasodilatory effects of both medications. This is the most critical adverse reaction the nurse should anticipate.
B. Bradycardia is not a direct effect of this combination; rather, hypotension is a more significant concern.
C. Chest pain may occur if hypotension leads to inadequate perfusion, but it is not a direct adverse effect of the drug interaction.
D. Nausea can occur with various medications, but it is not specifically linked to the interaction between nitroglycerin and sildenafil.