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 A, B, C, D, E
Explanation
Rationale:
- Administering albuterol first is crucial because it is a bronchodilator that will help open the airways before administering the anti-inflammatory fluticasone.
- The client should rest for 1 minute between puffs of albuterol to allow for the medication to take effect.
- After taking the second puff of albuterol, a longer rest of 5 minutes allows the client to experience the full effects of the bronchodilator.
- Finally, administering fluticasone afterward will help reduce inflammation in the airways, maximizing the benefit of both medications.
Correct Answer is C
Explanation
Rationale:
A. Magnesium 2.5 mEq/L: A magnesium level slightly above the normal range does not indicate an immediate need to discontinue clozapine, as this level is not related to the adverse effects of the drug.
B. Potassium 5.4 mEq/L: While elevated potassium levels can pose a health risk, this is not a direct indicator to discontinue clozapine. Potassium levels can be managed with other interventions.
C. WBC 2,500/mm³: Clozapine carries a risk of agranulocytosis, a condition where the white blood cell (WBC) count becomes dangerously low, leading to severe infection risk. A WBC count of 2,500/mm³ is below the normal range and indicates the need to discontinue clozapine immediately.
D. Sodium 134 mEq/L: A slightly low sodium level is not typically related to clozapine use and does not warrant discontinuation of the medication.