A nurse is preparing to administer verapamil to a client who is 2 days post-myocardial infarction. The nurse should monitor the client for which of the following outcomes as a therapeutic response to the medication?
Increased heart rate
Increased blood pressure
Decreased pulmonary congestion
Decreased anginal pain
The Correct Answer is D
Rationale:
A. Verapamil is a calcium channel blocker that typically decreases heart rate rather than increases it. Therefore, an increased heart rate would not be a therapeutic response to this medication.
B. Verapamil works to lower blood pressure by inhibiting calcium influx into the vascular smooth muscle. An increase in blood pressure would not be an expected therapeutic outcome.
C. While verapamil may help with heart function, the primary therapeutic response is not specifically measured by decreased pulmonary congestion. This outcome may not be directly observable in the early treatment phases post-myocardial infarction.
D. Verapamil is effective in reducing anginal pain by decreasing myocardial oxygen demand through lowering heart rate and contractility. Thus, a decrease in anginal pain would be a direct therapeutic response to the medication.
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Correct Answer is D
Explanation
Rationale:
A. This statement is incorrect because the client should remove contact lenses before administering brimonidine and wait at least 15 minutes before reinserting them to ensure proper absorption and avoid irritation.
B. While some mild irritation can occur, it is not a desired effect and should not be expected; the nurse should clarify what level of irritation is considered normal.
C. This statement is incorrect as brimonidine is typically a long-term treatment for glaucoma, and clients should not stop using it without consulting their provider.
D. This statement is correct; brimonidine can cause changes in eye color, particularly in individuals with lighter colored eyes, and the client should be informed about this possibility.
Correct Answer is D
Explanation
Rationale:
A. A respiratory rate of 24/min is elevated and may suggest respiratory distress, but it is not a specific adverse effect of propranolol.
B. An oral temperature of 38.9° C (102° F) indicates fever, which is not a typical adverse effect of propranolol.
C. A blood pressure of 118/78 mm Hg is within normal limits and does not indicate an adverse effect of propranolol, which is often used to manage hypertension.
D. An apical pulse of 50/min indicates bradycardia, a known adverse effect of propranolol, which can occur due to its action on the heart rate.