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
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.
Correct Answer is ["A","C","D"]
Explanation
A) Masking of hypoglycemia: Propranolol can mask the symptoms of hypoglycemia, such as tachycardia, which is important for clients with diabetes to be aware of. This means that while they may have low blood sugar, they might not experience the typical warning signs due to the medication's effects on the autonomic nervous system.
B) Tachycardia: Propranolol is a beta-blocker that is used to reduce heart rate and blood pressure. Therefore, tachycardia is not a side effect associated with this medication; in fact, it generally works to prevent this condition.
C) Bradycardia: Bradycardia, or a slow heart rate, is a common side effect of propranolol due to its action on beta-adrenergic receptors. Clients should be educated about monitoring their heart rate and reporting any significant drops.
D) Orthostatic Hypotension: This is a potential side effect of propranolol, especially when starting the medication or increasing the dose. Clients should be advised to rise slowly from sitting or lying positions to minimize the risk of dizziness or fainting.
E) Hypertension: Propranolol is prescribed to manage hypertension, so it should not be expected as a side effect. In fact, it is intended to lower blood pressure, and clients should be educated that they should not experience increased hypertension while taking this medication.