The nurse is caring for a client who experienced a dry-non productive cough associated with an ACE inhibitor. Which of the following drugs is an alternative to ACE inhibitors?
losartan (Cozaar)
metoprolol (Lopressor)
furosemide (Lasix)
hydralazine HCL (Apresoline)
The Correct Answer is A
A. Losartan is an angiotensin receptor blocker (ARB) that serves as an effective alternative to ACE inhibitors, particularly for patients who experience cough as a side effect.
B. Metoprolol is a beta-blocker, which is not a direct alternative to ACE inhibitors and is used for different indications such as heart rate and blood pressure control.
C. Furosemide is a diuretic that does not directly substitute for the actions of ACE inhibitors.
D. Hydralazine is a direct vasodilator used for hypertension but does not share the same mechanism as ACE inhibitors or serve as a direct alternative.
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Correct Answer is D
Explanation
A. A pulse oximetry of 92% indicates potential hypoxia but is not a direct contraindication for administering verapamil.
B. A respiratory rate of 12 is not an immediate concern for verapamil; it is considered a normal rate in many cases.
C. A recent history of myocardial infarction does not automatically contraindicate verapamil but should be assessed in the context of the client’s overall health and physician’s orders.
D. A pulse of 78 is within a normal range; however, if the pulse were significantly low (e.g., below 60 bpm), verapamil would generally be held due to its potential to further decrease heart rate.
Correct Answer is C
Explanation
A. Calcium channel blockers are not typically used to manage flushing associated with niacin.
B. NSAIDs can help with flushing symptoms; however, beta blockers are more commonly used for this purpose.
C. Beta blockers, such as propranolol, are effective in preventing flushing associated with niacin therapy by blocking the vasodilatory effects.
D. Fibric acid derivatives are used to lower triglycerides and cholesterol but do not address flushing caused by niacin.