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","D","E"]
Explanation
Rationale:
A. Blurred vision is a common side effect of anticholinergic medications due to their effect on the eye muscles and pupil dilation.
B. Polyuria is not typically associated with anticholinergic medications; these medications may actually lead to urinary retention.
C. A productive cough is not an expected adverse effect of anticholinergic medications; instead, they may cause dry mucous membranes and a dry cough.
D. Tachycardia can occur as anticholinergic medications block the effects of acetylcholine on the heart, leading to increased heart rate.
E. Constipation is a well-known side effect of anticholinergic medications because they reduce gastrointestinal motility.
Correct Answer is D
Explanation
Rationale:
A. Mostly cloudy: This option appears to be incorrectly stated. It does not pertain to a critical client assessment related to morphine administration.
B. Apical heart rate: Monitoring the heart rate is important, but respiratory depression is a more immediate and life-threatening concern with morphine administration, so it is not the first priority.
C. Blood pressure: Morphine can cause hypotension, but this is not as critical as respiratory depression, which must be assessed first in opioid administration.
D. Respiratory rate: The most critical assessment when administering morphine is the respiratory rate, as opioid medications like morphine can cause respiratory depression, which can be life-threatening if not addressed.
E. Level of consciousness: While important, changes in consciousness typically follow respiratory depression, so assessing the respiratory rate takes priority.