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. 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 C
Explanation
A. This insulin does not peak like short-acting insulin; glargine provides a consistent release of insulin without a peak effect.
B. Long-acting insulin is not meant to be taken with meals, as it provides basal control and is typically taken once daily, not with each meal.
C. This statement is correct; glargine provides a steady level of insulin over 24 hours, helping to maintain consistent blood glucose levels throughout the day and night.
D. Long-acting insulin is usually administered once daily, so stating that it must be given three times a day is incorrect.