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. 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.
Correct Answer is A
Explanation
Rationale:
A. Increase calcium intake: Leuprolide can cause a decrease in bone density, increasing the risk of osteoporosis. Therefore, the nurse should advise the client to increase calcium and vitamin D intake to help maintain bone health.
B. Keep the solution cold for administration: Leuprolide should be stored at room temperature, not refrigerated, for subcutaneous administration.
C. This medication can cause low blood glucose levels: Leuprolide does not typically affect blood glucose levels. However, it can cause other endocrine-related side effects, such as hot flashes and reduced libido.
D. This medication can cause constipation: Constipation is not a common side effect of leuprolide. Instead, leuprolide is more likely to cause side effects such as hot flashes and loss of bone density.