The nurse is caring for a client with a history of hypertension who has experienced uncontrollable non-productive cough related to an ACE inhibitor. Which alternative medication would the nurse anticipate administering?
losartan (Cozaar)
hydralazine HCL (Apresoline)
furosemide (Lasix)
metoprolol (Lopressor)
The Correct Answer is A
A) Losartan (Cozaar): This medication is an angiotensin II receptor blocker (ARB) and is often used as an alternative for patients who experience a cough due to ACE inhibitors. Unlike ACE inhibitors, ARBs do not typically cause a cough because they do not affect bradykinin levels, making losartan an appropriate choice for managing hypertension without the adverse effect of a persistent cough.
B) Hydralazine HCL (Apresoline): While hydralazine is an antihypertensive, it works through a different mechanism (direct vasodilation) and is not a first-line alternative for patients with a history of ACE inhibitor-induced cough. It's generally used in specific situations, such as severe hypertension or heart failure.
C) Furosemide (Lasix): This is a loop diuretic primarily used for conditions like heart failure or edema, rather than for the management of hypertension alone. It does not address the underlying hypertension in the same manner as ACE inhibitors or ARBs.
D) Metoprolol (Lopressor): This is a beta-blocker that can be used for hypertension, but it does not directly address the issue of cough related to ACE inhibitors. Switching to a beta-blocker may not be the best option if the client is specifically seeking to avoid the cough associated with ACE inhibitors.
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View Related questions
Correct Answer is A
Explanation
A) Inhibits platelet aggregation: The primary benefit of aspirin following a myocardial infarction (MI) is its ability to inhibit platelet aggregation. By preventing platelets from clumping together, aspirin reduces the risk of further clot formation, which is critical in preventing additional cardiac events and improving overall cardiovascular outcomes.
B) Anti-inflammatory properties: While aspirin does have anti-inflammatory effects, this is not the primary reason it is prescribed after an MI. The focus in the post-MI setting is on its role in preventing clot formation rather than addressing inflammation.
C) Antiemetic: Aspirin is not an antiemetic and does not alleviate nausea or vomiting. Clients experiencing gastrointestinal issues or nausea would require different medications for those symptoms.
D) Anti-pyretic: Although aspirin can reduce fever, this effect is not the primary concern in the post-MI setting. The immediate goal is to improve heart health and prevent further thrombotic events, making platelet inhibition the most relevant benefit.
Correct Answer is ["A","B","C","D","E"]
Explanation
A) Angioedema: Quinapril, an ACE inhibitor, can cause angioedema, which is a serious allergic reaction characterized by swelling of the deeper layers of the skin. This side effect is critical to monitor, as it can lead to airway obstruction.
B) Dry non-productive cough: A persistent dry cough is a well-known side effect of ACE inhibitors like quinapril. This occurs due to the accumulation of bradykinin and can be bothersome enough to require discontinuation of the medication.
C) Hyperkalemia: Quinapril can lead to increased potassium levels in the blood, a condition known as hyperkalemia. This is due to the drug's mechanism of action, which reduces aldosterone secretion, leading to decreased potassium excretion.
D) First dose phenomenon: This refers to a significant drop in blood pressure following the first dose of an ACE inhibitor, which can lead to dizziness or fainting. Patients are often advised to take the first dose at bedtime to minimize this risk.
E) Hypotension: Quinapril can cause hypotension, particularly after the initial dosing or in patients who are dehydrated or on diuretics. It’s important for patients to be aware of this potential side effect.
F) Hypertension: Quinapril is used to treat hypertension, so it is not a side effect associated with this medication. Instead, the goal of treatment is to lower blood pressure, making this option incorrect.