An older adult client with hypertension has recently been prescribed a beta-adrenergic blocker and a thiazide diuretic. When educating the client about preventing and managing adverse effects, the nurse will provide which instruction?
"Change positions slowly to prevent lightheadedness or dizziness."
"Reduce your fluid intake initially, to prevent excessive urination."
"Identify and eliminate any high-potassium foods from your diet."
"Expect your blood pressure to increase for several days before it begins to decrease."
The Correct Answer is A
A. Changing positions slowly is critical for older adults taking beta-adrenergic blockers and diuretics to prevent orthostatic hypotension, which can lead to lightheadedness or dizziness.
B. Reducing fluid intake is not advisable, as thiazide diuretics can lead to dehydration, and maintaining adequate fluid intake is essential for overall health and to avoid excessive urinary output.
C. Identifying and eliminating high-potassium foods is unnecessary unless there is a specific indication of hyperkalemia, particularly since thiazide diuretics do not typically cause potassium retention, and beta-blockers are not potassium-specific.
D. Expecting blood pressure to increase before it decreases is misleading; clients should see a gradual reduction in blood pressure with proper medication adherence, and any sudden increases should be reported.
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Correct Answer is D
Explanation
A. While MAOIs may have some regulatory considerations, they are not classified under a scheduled drug classification like controlled substances.
B. MAOIs are effective in treating depression and anxiety disorders, which is not the reason for their limited use.
C. Although MAOIs can have some side effects, they are more notably associated with dietary and drug interactions rather than causing GI bleeding or esophageal varices.
D. MAOIs can cause dangerous interactions with foods that contain tyramine (like aged cheeses and fermented products) and certain medications, leading to hypertensive crises, making their use cautious and limiting in clinical practice.
Correct Answer is A
Explanation
A. Pseudoephedrine is a decongestant that can raise blood pressure and cause increased heart rate, so it is essential to assess the patient’s history of hypertension before starting this medication.
B. While a dry cough may be relevant for other medications, it is not a primary concern when assessing for the use of pseudoephedrine.
C. Recent use of antibiotics is not directly related to the safety of using pseudoephedrine and is not a typical concern.
D. A history of seizures is not a specific contraindication for using pseudoephedrine, although it may warrant caution in some cases.