A client with a long-standing diagnosis of angina has been prescribed nitroglycerin and diltiazem. In addition to monitoring the client's heart rate, the nurse should prioritize what assessment?
Blood pressure
Level of consciousness
Daily weights
Respiratory status
The Correct Answer is A
A. Blood pressure is correct because both nitroglycerin and diltiazem can cause vasodilation, leading to hypotension; thus, monitoring blood pressure is crucial for patient safety.
B. Level of consciousness is incorrect; while important, it is not the primary concern in this context.
C. Daily weights are incorrect; they are more relevant for assessing fluid status over time, not immediate drug effects.
D. Respiratory status is incorrect; while monitoring is important, blood pressure takes precedence due to the risk of hypotension associated with these medications.
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Correct Answer is B
Explanation
A. Decreased appetite may occur but is not the most critical concern in this context.
B. The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.
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.