A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
possible drug toxicity.
decreased therapeutic effects.
altered drug absorption.
increased drug metabolism.
The Correct Answer is A
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.
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Correct Answer is B
Explanation
A. Rebound hypertension can occur if antihypertensive medications are abruptly stopped, but it is not a direct reason for switching from an ACE inhibitor to an angiotensin II receptor blocker.
B. A persistent cough is a well-known side effect of ACE inhibitors due to the accumulation of bradykinin. If the client experienced this side effect, it would likely prompt the healthcare provider to switch to an angiotensin II receptor blocker, which does not typically cause this issue.
C. A transient ischemic attack (TIA) would require urgent intervention but is not a reason for changing from an ACE inhibitor to an angiotensin II receptor blocker.
D. Non-adherence to ACE inhibitor treatment may lead to ineffective blood pressure control but would not directly justify a switch to a different class of medication.
Correct Answer is B
Explanation
A. Antibiotics do not typically interact with adrenergic drugs in a way that would necessitate contacting the healthcare provider before administration.
B. MAO inhibitors can cause significant interactions with adrenergic drugs, potentially leading to hypertensive crises due to increased norepinephrine levels. Therefore, the nurse should contact the healthcare provider to assess the risks before administering an adrenergic agent.
C. Diuretics may affect fluid and electrolyte balance, but they do not pose a direct interaction risk with adrenergic drugs that would require prior consultation with the healthcare provider.
D. Analgesics do not have a significant interaction with adrenergic drugs that would warrant contacting the healthcare provider, as they are used for pain management and can often be safely administered together.