The nurse is caring for a client newly diagnosed with hypertension and requires medication therapy. Which of the following medications below is considered a first line treatment for hypertension?
carvedilol
lisinopril
clonidine
doxazosin
The Correct Answer is B
A) Carvedilol: While carvedilol is a beta-blocker that can be used to treat hypertension, it is not considered a first-line treatment. Beta-blockers are typically used when other first-line agents are not effective or in specific situations such as heart failure or ischemic heart disease.
B) Lisinopril: Lisinopril is an ACE inhibitor and is considered a first-line treatment for hypertension. It effectively reduces blood pressure by inhibiting the angiotensin-converting enzyme, leading to vasodilation and decreased blood volume. Its well-documented efficacy and favorable side effect profile make it a common choice for initial therapy.
C) Clonidine: Clonidine is an alpha-2 adrenergic agonist that can lower blood pressure but is generally not used as a first-line treatment due to its side effects and potential for rebound hypertension if discontinued abruptly.
D) Doxazosin: Doxazosin is an alpha-1 blocker that can be used to treat hypertension but is not typically a first-line choice. It may be used in specific cases, such as in patients with benign prostatic hyperplasia, but other classes of medications are usually preferred for initial hypertension treatment.
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Correct Answer is D
Explanation
A) Pancytopenia: While some medications can cause pancytopenia, it is not a common or direct side effect of alteplase. This condition involves a reduction in red blood cells, white blood cells, and platelets, and is not typically associated with thrombolytics.
B) Hypertension: Alteplase is not known to cause hypertension. In fact, the goal of administering alteplase in the context of a pulmonary embolism is to dissolve the clot and restore normal blood flow, which may help stabilize blood pressure.
C) Hypokalemia: This condition, characterized by low potassium levels, is not a common side effect of alteplase. There are other medications that may cause electrolyte imbalances, but alteplase itself is not typically linked to hypokalemia.
D) Internal bleeding: This is a significant risk associated with alteplase, as it is a thrombolytic agent that dissolves clots. The nurse should closely monitor for signs of internal bleeding, such as changes in vital signs, unexplained bruising, or blood in urine or stool. This is the most critical side effect to assess for in a client receiving alteplase
Correct Answer is D
Explanation
A. "Depending on the level of your PT/INR, the clot will begin to dissolve.": This response is misleading, as heparin's effect is not primarily monitored by PT/INR; rather, heparin is monitored by activated partial thromboplastin time (aPTT). Moreover, heparin does not directly dissolve clots; it prevents further clot formation.
B. "After the first dose, the clot will begin to dissolve.": This statement inaccurately suggests that heparin has an immediate effect on dissolving existing clots. While heparin acts quickly to inhibit further clotting, it does not lead to the dissolution of clots after the first dose.
C. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.": This is not accurate for heparin, which has an immediate effect on coagulation. While the therapeutic effects can be optimized over several days, heparin begins to work right away to prevent further clotting.
D. "Heparin does not dissolve clots. It stops new clots from forming.": This response accurately describes the mechanism of action of heparin. Heparin prevents the extension of existing clots and the formation of new clots, but it does not actively dissolve clots. This clarification is essential for the client’s understanding of their treatment and expectations regarding DVT management.