A client presents to the healthcare setting and ordered verapamil to treat his hypertension. Which assessment finding by the nurse would determine if the medication should be held?
Pulse oximetry of 92%
Pulse of 78
Respiratory rate of 12
History of a myocardial infarction a week ago
The Correct Answer is D
A) Pulse oximetry of 92%: While a pulse oximetry reading of 92% is slightly below normal, it is not a definitive reason to hold verapamil. This reading indicates mild hypoxemia, but it does not directly contraindicate the use of verapamil. Other factors should be considered before making a decision based solely on this value.
B) Pulse of 78: A pulse rate of 78 beats per minute is within the normal range for adults and does not warrant holding verapamil. This finding alone does not indicate any immediate concerns related to the administration of the medication.
C) Respiratory rate of 12: A respiratory rate of 12 breaths per minute is within the normal range for adults. This finding does not provide any indication that verapamil should be withheld. It is important to consider other clinical factors when assessing the appropriateness of medication administration.
D) History of myocardial infarction a week ago: Verapamil, a calcium channel blocker, can have significant effects on cardiac function. Administering it to a client who recently experienced a myocardial infarction (heart attack) could exacerbate cardiac issues and lead to complications. Therefore, it is crucial to hold the medication and consult with the healthcare provider before proceeding.
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Correct Answer is B
Explanation
A) Carvedilol: While carvedilol is a beta-blocker that can be used to treat hypertension, it is not considered a first-line treatment. Beta-blockers are typically used when other first-line agents are not effective or in specific situations such as heart failure or ischemic heart disease.
B) Lisinopril: Lisinopril is an ACE inhibitor and is considered a first-line treatment for hypertension. It effectively reduces blood pressure by inhibiting the angiotensin-converting enzyme, leading to vasodilation and decreased blood volume. Its well-documented efficacy and favorable side effect profile make it a common choice for initial therapy.
C) Clonidine: Clonidine is an alpha-2 adrenergic agonist that can lower blood pressure but is generally not used as a first-line treatment due to its side effects and potential for rebound hypertension if discontinued abruptly.
D) Doxazosin: Doxazosin is an alpha-1 blocker that can be used to treat hypertension but is not typically a first-line choice. It may be used in specific cases, such as in patients with benign prostatic hyperplasia, but other classes of medications are usually preferred for initial hypertension treatment.
Correct Answer is A
Explanation
A) Inhibits platelet aggregation: The primary benefit of aspirin following a myocardial infarction (MI) is its ability to inhibit platelet aggregation. By preventing platelets from clumping together, aspirin reduces the risk of further clot formation, which is critical in preventing additional cardiac events and improving overall cardiovascular outcomes.
B) Anti-inflammatory properties: While aspirin does have anti-inflammatory effects, this is not the primary reason it is prescribed after an MI. The focus in the post-MI setting is on its role in preventing clot formation rather than addressing inflammation.
C) Antiemetic: Aspirin is not an antiemetic and does not alleviate nausea or vomiting. Clients experiencing gastrointestinal issues or nausea would require different medications for those symptoms.
D) Anti-pyretic: Although aspirin can reduce fever, this effect is not the primary concern in the post-MI setting. The immediate goal is to improve heart health and prevent further thrombotic events, making platelet inhibition the most relevant benefit.