A client taking diltiazem, a calcium channel blocker, for hypertension has come to the clinic for a follow-up appointment. The nurse will assess the client for which adverse effects?
Chest pain and pale skin
Shortness of breath and wheezing
Peripheral edema and bradycardia
Tachycardia and anxiety
The Correct Answer is C
A. Chest pain and pale skin are not typical adverse effects associated with diltiazem use.
B. Shortness of breath and wheezing may occur due to other conditions or medications but are not common adverse effects of diltiazem.
C. Calcium channel blockers like diltiazem can cause peripheral edema due to vasodilation and bradycardia as a result of their action on the heart rate. Monitoring for these effects is essential in patients taking diltiazem.
D. Tachycardia is not an expected adverse effect of diltiazem; in fact, it is used to manage conditions where tachycardia may be present. Anxiety is also not a direct adverse effect of this medication.
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Correct Answer is A
Explanation
A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.
B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.
C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.
D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.
Correct Answer is D
Explanation
A. Liver failure does not have a direct contraindication with bronchodilators, though careful monitoring is needed.
B. Renal failure is not a direct contraindication for bronchodilator use; however, kidney function can affect drug metabolism and clearance.
C. Respiratory failure may necessitate bronchodilator therapy rather than caution, especially in conditions like COPD or asthma where bronchodilators are crucial for management.
D. Heart failure requires caution with bronchodilators because they can lead to increased heart rate and blood pressure, potentially exacerbating heart failure symptoms or leading to arrhythmias.