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 D
Explanation
A. The patient’s statement about the peak of NPH insulin being 6-12 hours is correct; it is important to know when to monitor for hypoglycemia.
B. Taking NPH before breakfast is appropriate, as it is typically given in the morning to provide coverage for meals throughout the day.
C. The duration of NPH insulin lasting for 12-18 hours is accurate, which is crucial for understanding how long the patient can expect blood glucose control.
D. NPH insulin should not be taken right before meals as it does not act quickly enough to cover immediate carbohydrate intake. Rapid-acting insulin is typically used for that purpose, indicating a need for further teaching.
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.