A client presents to the healthcare setting after beginning treatment with an Angiotensin Converting Enzyme (ACE) inhibitor. Which of the following side- effects will the nurse be sure to assess for?
Dry, non-productive cough
Nausea and vomiting
Hypokalemia and vomiting
Epistaxis and headache
The Correct Answer is A
A) Dry, non-productive cough: One of the most common side effects associated with ACE inhibitors is a dry, non-productive cough. This occurs due to the accumulation of bradykinin, a peptide that can increase in the body when ACE is inhibited. Nurses should assess for this symptom, as it may require changing the medication if it becomes bothersome to the client.
B) Nausea and vomiting: While nausea and vomiting can occur with various medications, they are not specific or common side effects of ACE inhibitors. If these symptoms do arise, they may be due to other factors and should be investigated further.
C) Hypokalemia and vomiting: ACE inhibitors are more commonly associated with hyperkalemia (elevated potassium levels) rather than hypokalemia. Monitoring potassium levels is important, but vomiting is not a typical side effect of ACE inhibitors.
D) Epistaxis and headache: Although headaches can occur with many medications, epistaxis (nosebleeds) is not a common side effect associated with ACE inhibitors. While headache assessment is appropriate, the dry cough is the more characteristic and important symptom to monitor in clients on these medications.
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View Related questions
Correct Answer is A
Explanation
A) Hypokalemia: Hypokalemia, or low potassium levels, significantly increases the risk of digoxin toxicity. Since digoxin competes with potassium for binding at the sodium-potassium ATPase site in the heart, low potassium levels can lead to increased digoxin effects and toxicity. Therefore, it is crucial to monitor potassium levels and correct any deficiencies before administering digoxin.
B) Hyperkalemia: While hyperkalemia is a serious concern and can also affect digoxin therapy, it usually results in decreased effectiveness of digoxin rather than increasing toxicity. Elevated potassium levels can diminish the drug's positive inotropic effect.
C) Hypocalcemia: Although calcium levels can influence cardiac function, hypocalcemia is not directly related to digoxin toxicity. Monitoring calcium is important for overall cardiac health, but it is not the primary focus when assessing the risk for digoxin toxicity.
D) Hypernatremia: Elevated sodium levels do not have a direct impact on the efficacy or toxicity of digoxin. While sodium levels are essential to monitor for overall health, they are not critical in the context of digoxin administration and toxicity risk.
Correct Answer is D
Explanation
A) Atenolol: This is a beta-blocker that can be used for various cardiac conditions, including hypertension and certain arrhythmias, but it is not typically the first-line treatment for acute life-threatening ventricular dysrhythmias in the emergency setting.
B) Lisinopril: This medication is an ACE inhibitor primarily used to manage hypertension and heart failure. It does not address acute ventricular dysrhythmias and would not be appropriate for immediate use in this scenario.
C) Adenosine: While adenosine is effective for certain types of supraventricular tachycardia, it is not indicated for life-threatening ventricular dysrhythmias. It has a very short duration of action and is not the drug of choice in this context.
D) Procainamide: This antiarrhythmic medication is specifically used to treat life-threatening ventricular dysrhythmias. It works by stabilizing the cardiac membrane and is indicated in emergency situations to manage these types of arrhythmias. Therefore, preparing procainamide is the most appropriate action for the nurse in this scenario.