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 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.
Correct Answer is D
Explanation
A. By directly relaxing vascular smooth muscle is not how lisinopril primarily works; it does not act directly on smooth muscle but rather affects hormonal pathways.
B. By blocking aldosterone from binding to mineralocorticoid receptors is a secondary effect of the angiotensin-converting enzyme (ACE) inhibitors but not the primary action of lisinopril itself.
C. By blocking the movement of calcium ions into arterial smooth muscles describes the action of calcium channel blockers, not ACE inhibitors like lisinopril.
D. By inhibiting the transformation of angiotensin I to angiotensin II is the correct answer because lisinopril inhibits the ACE enzyme, reducing the production of angiotensin II, which lowers blood pressure and decreases strain on the heart.