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) Pulse oximetry of 92%: While a pulse oximetry reading of 92% is slightly below normal, it is not a definitive reason to hold verapamil. This reading indicates mild hypoxemia, but it does not directly contraindicate the use of verapamil. Other factors should be considered before making a decision based solely on this value.
B) Pulse of 78: A pulse rate of 78 beats per minute is within the normal range for adults and does not warrant holding verapamil. This finding alone does not indicate any immediate concerns related to the administration of the medication.
C) Respiratory rate of 12: A respiratory rate of 12 breaths per minute is within the normal range for adults. This finding does not provide any indication that verapamil should be withheld. It is important to consider other clinical factors when assessing the appropriateness of medication administration.
D) History of myocardial infarction a week ago: Verapamil, a calcium channel blocker, can have significant effects on cardiac function. Administering it to a client who recently experienced a myocardial infarction (heart attack) could exacerbate cardiac issues and lead to complications. Therefore, it is crucial to hold the medication and consult with the healthcare provider before proceeding.
Correct Answer is C
Explanation
A) Beta Blockers: While beta blockers can be used to manage some side effects of various medications, they are not typically indicated for managing niacin-induced flushing. Their primary use is in cardiovascular conditions rather than specifically addressing flushing.
B) Calcium Channel Blockers: Calcium channel blockers are primarily used to treat hypertension and certain heart conditions. They do not specifically address the flushing associated with niacin and would not be the expected choice for this side effect.
C) NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective in managing niacin-induced flushing. Administering an NSAID, such as ibuprofen, prior to taking niacin can help reduce the flushing response by inhibiting the prostaglandins that contribute to this side effect.
D) Fibric Acid Derivatives: These medications, such as gemfibrozil, are used to lower triglycerides and cholesterol levels, but they do not address the flushing side effect caused by niacin. Their mechanism of action is different and not focused on alleviating flushing symptoms.