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 ["C","D","E","F"]
Explanation
A) Constipation: While constipation can occur with digoxin use, it is not a classic sign of digoxin toxicity. Therefore, it is less critical for the client to monitor this symptom specifically in relation to toxicity.
B) Dark red urine: Dark red urine is not typically associated with digoxin toxicity. This symptom could indicate other conditions, such as blood in the urine or issues with the kidneys, but it is not a direct manifestation of digoxin toxicity.
C) Bradycardia: Digoxin toxicity can lead to bradycardia, characterized by a slower than normal heart rate. The client should be instructed to monitor their pulse and report any significant changes, especially if the heart rate drops below 60 beats per minute.
D) Nausea: Nausea is a common symptom of digoxin toxicity. Clients should be aware of this and report any persistent or severe nausea, as it may indicate that the digoxin levels in their system are too high.
E) Vomiting: Vomiting is another classic sign of digoxin toxicity. Clients should be instructed to report any episodes of vomiting, as this can further complicate their condition and may require adjustment of their medication.
F) Anorexia: Anorexia, or loss of appetite, can also occur with digoxin toxicity. Clients should be advised to monitor their appetite and report any significant changes, as this can be an early indicator of toxicity.
Correct Answer is B
Explanation
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.