The nurse is educating a client on the possible side effects associated with quinapril. Which of the following side effects are associated with this medication classification?(Select All that Apply)
angioedema
dry non-productive cough
hyperkalemia
first dose phenomenon
hypotension
Hypertension
Correct Answer : A,B,C,D,E
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.
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Correct Answer is A
Explanation
A) Gallstones: Gemfibrozil is associated with an increased risk of gallstones. This medication can alter the metabolism of lipids and bile, potentially leading to the formation of gallstones. Clients should be monitored for symptoms such as abdominal pain or discomfort that could indicate gallbladder issues.
B) Decreased PT time: Gemfibrozil does not typically affect prothrombin time (PT). Instead, it may interact with anticoagulants and potentially increase PT time, requiring careful monitoring in patients taking both medications.
C) Hyperkalemia: While hyperkalemia can occur with certain lipid-lowering medications, it is not a common side effect associated with gemfibrozil. This drug primarily affects triglycerides and cholesterol levels without significantly impacting potassium levels.
D) Increased creatinine clearance: Gemfibrozil is not known to increase creatinine clearance; in fact, it can sometimes affect renal function. Monitoring kidney function is important, but increased creatinine clearance is not an expected outcome with this medication.
Correct Answer is D
Explanation
A) "Increase your potassium intake by eating more bananas and apricots.": Doxazosin is not a potassium-sparing medication, and there is no specific indication for increased potassium intake with this drug. This advice may be misleading, especially since excessive
potassium can pose risks, particularly in certain populations.
B) "Weigh yourself daily, and report any weight loss to your prescriber.": Daily weighing can be important for monitoring fluid retention in some conditions, but weight loss is not a common side effect of doxazosin. Instead, clients should be more concerned about weight gain due to fluid retention or potential side effects from the medication.
C) "The impaired taste associated with this medication usually goes away in 2 to 3 weeks.": Impaired taste is not a well-documented side effect of doxazosin. While some medications may cause changes in taste, this statement is not relevant for doxazosin and does not address the most critical aspects of its administration.
D) "Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy.": This statement is accurate and important. Doxazosin can cause first-dose hypotension, leading to dizziness or fainting. Advising the client to lie down after the first dose helps mitigate the risk of hypotensive effects, making this the most appropriate emphasis for the nurse.