A nurse is caring for a client who has a prescription for hydrochlorothiazide for the initial treatment of hypertension. Which of the following should the nurse recognize as the action of this medication?
Hydrochlorothiazide prevents angiotensin II from binding with receptor sites.
Hydrochlorothiazide decreases the reabsorption of sodium and water in the distal renal tubule.
Hydrochlorothiazide blocks stimulation of beta receptors in the sympathetic nervous system.
Hydrochlorothiazide promotes the movement of extravascular fluids into the vascular compartment.
The Correct Answer is B
Rationale:
A. Hydrochlorothiazide does not prevent angiotensin II from binding with receptor sites; this action is typically associated with ACE inhibitors or angiotensin receptor blockers.
B. Hydrochlorothiazide decreases the reabsorption of sodium and water in the distal renal tubule, which leads to increased urine output and decreased blood volume, effectively lowering blood pressure.
C. Hydrochlorothiazide does not block beta receptors; this is the mechanism of action for beta-blockers.
D. Hydrochlorothiazide does not promote the movement of extravascular fluids into the vascular compartment; instead, it reduces blood volume by promoting diuresis.
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Correct Answer is B
Explanation
Rationale:
A. A decrease in the amount of gastric acid production: Alosetron is not used to decrease gastric acid production. This effect is more associated with medications such as proton pump inhibitors or H2 blockers.
B. A decrease in the frequency of defecation: Alosetron is used to treat irritable bowel syndrome with diarrhea (IBS-D) by reducing bowel movement frequency and improving stool consistency.
C. An increase in gastric motility: Alosetron works by decreasing intestinal motility, which helps reduce diarrhea, not by increasing it.
D. An increase in the absorption of water into the intestine: Alosetron does not specifically increase water absorption into the intestine. Its primary effect is slowing intestinal transit to reduce diarrhea.
Correct Answer is A
Explanation
Rationale:
A. Increase fluids while taking the medication: Amitriptyline is a tricyclic antidepressant that can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps to mitigate these effects and prevent dehydration and constipation.
B. Expect an elevation in blood pressure with initial doses of the medication: Amitriptyline can cause orthostatic hypotension rather than elevated blood pressure. Clients should be informed about the risk of dizziness or fainting.
C. Stop the medication immediately if urine becomes orange in color: Orange urine is not a common side effect of amitriptyline. Clients should not stop the medication without consulting their provider.
D. Take the medication in the morning: Amitriptyline has sedative effects and is typically taken at night to help manage sleep disturbances and reduce daytime drowsiness.