A nurse is caring for a client admitted to the intensive care unit for a cardiac dysrhythmia. The nurse understands the prescribed calcium channel blocker has which of the following mechanisms of action?
Acts on the beta cells within the heart and lungs to regulate cardiac rhythm
Increases heart rate and increases myocardial contractility
Reduces the contractility and conductivity of the heart
Increase oxygen to the systemic circulation
The Correct Answer is C
A) "Acts on the beta cells within the heart and lungs to regulate cardiac rhythm.": This statement is incorrect because calcium channel blockers do not primarily act on beta cells. Instead, they block calcium channels in cardiac and smooth muscle, which affects heart contractility and conductivity.
B) "Increases heart rate and increases myocardial contractility.": Calcium channel blockers typically do the opposite; they decrease heart rate and myocardial contractility by inhibiting calcium entry into the heart muscle cells. Therefore, this statement does not accurately describe their mechanism of action.
C) "Reduces the contractility and conductivity of the heart.": This statement accurately reflects the action of calcium channel blockers. By blocking calcium entry, these medications decrease myocardial contractility and slow down electrical conduction through the heart, which can help manage dysrhythmias.
D) "Increase oxygen to the systemic circulation.": While calcium channel blockers can improve blood flow and reduce myocardial oxygen demand by decreasing heart workload, their primary action does not directly focus on increasing oxygen delivery to systemic circulation. Their primary role is in managing heart contractility and rhythm.
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Correct Answer is C
Explanation
A) Migraine headache: While migraines can be uncomfortable and distressing, they are not a known serious side effect of atorvastatin. Clients may experience headaches, but this symptom does not typically require immediate reporting unless accompanied by other concerning signs.
B) Bradycardia: Bradycardia, or a slow heart rate, is not a common side effect of atorvastatin. While monitoring heart rate is important, bradycardia alone does not necessitate immediate reporting unless it leads to significant symptoms or complications.
C) Dark-red urine: Dark-red urine is a concerning finding that could indicate serious conditions, such as hematuria or rhabdomyolysis, particularly when associated with statin use. This symptom requires immediate reporting to the healthcare provider, as it may signify potential muscle breakdown or kidney issues, which are serious complications of atorvastatin therapy.
D) Elevated HDL cholesterol: Increased levels of HDL (high-density lipoprotein) cholesterol are generally considered beneficial and a positive outcome of treatment. Therefore, this finding would not necessitate immediate reporting to the healthcare provider.
Correct Answer is ["A","C","D"]
Explanation
A) Masking of hypoglycemia: Propranolol can mask the symptoms of hypoglycemia, such as tachycardia, which is important for clients with diabetes to be aware of. This means that while they may have low blood sugar, they might not experience the typical warning signs due to the medication's effects on the autonomic nervous system.
B) Tachycardia: Propranolol is a beta-blocker that is used to reduce heart rate and blood pressure. Therefore, tachycardia is not a side effect associated with this medication; in fact, it generally works to prevent this condition.
C) Bradycardia: Bradycardia, or a slow heart rate, is a common side effect of propranolol due to its action on beta-adrenergic receptors. Clients should be educated about monitoring their heart rate and reporting any significant drops.
D) Orthostatic Hypotension: This is a potential side effect of propranolol, especially when starting the medication or increasing the dose. Clients should be advised to rise slowly from sitting or lying positions to minimize the risk of dizziness or fainting.
E) Hypertension: Propranolol is prescribed to manage hypertension, so it should not be expected as a side effect. In fact, it is intended to lower blood pressure, and clients should be educated that they should not experience increased hypertension while taking this medication.