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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View Related questions
Correct Answer is D
Explanation
A) "This medication decreases chest pain by dissolving blood clots that are occluding the arteries.": This statement is incorrect because nitroglycerin does not dissolve blood clots. Instead, it works by relaxing and dilating blood vessels, which helps improve blood flow to the heart muscle and relieve angina.
B) "Place one tablet under your tongue every 15 minutes and repeat up to 5 times for relief of chest pain.": This is not accurate; while nitroglycerin can be taken sublingually, the typical recommendation is to take one tablet every 5 minutes as needed for chest pain, not every 15 minutes, and not to exceed 3 tablets within 15 minutes.
C) "This medication is the first-line treatment for hypertension.": Although nitroglycerin can lower blood pressure, it is not typically considered a first-line treatment for hypertension. It is primarily used for angina relief rather than as a primary antihypertensive agent.
D) "This medication dilates cardiac blood vessels to deliver more oxygen to the heart.": This statement accurately describes the action of nitroglycerin. By dilating the coronary arteries, nitroglycerin increases blood flow and oxygen delivery to the heart muscle, which helps alleviate angina symptoms. This is a key point to emphasize during patient education.
Correct Answer is A
Explanation
A) Hypokalemia: Hypokalemia, or low potassium levels, significantly increases the risk of digoxin toxicity. Since digoxin competes with potassium for binding at the sodium-potassium ATPase site in the heart, low potassium levels can lead to increased digoxin effects and toxicity. Therefore, it is crucial to monitor potassium levels and correct any deficiencies before administering digoxin.
B) Hyperkalemia: While hyperkalemia is a serious concern and can also affect digoxin therapy, it usually results in decreased effectiveness of digoxin rather than increasing toxicity. Elevated potassium levels can diminish the drug's positive inotropic effect.
C) Hypocalcemia: Although calcium levels can influence cardiac function, hypocalcemia is not directly related to digoxin toxicity. Monitoring calcium is important for overall cardiac health, but it is not the primary focus when assessing the risk for digoxin toxicity.
D) Hypernatremia: Elevated sodium levels do not have a direct impact on the efficacy or toxicity of digoxin. While sodium levels are essential to monitor for overall health, they are not critical in the context of digoxin administration and toxicity risk.