What adverse reaction does the nurse anticipate if a client takes nitroglycerin with sildenafil?
Hypotension
Bradycardia
Chest pain
Nausea
The Correct Answer is A
A. The combination of nitroglycerin and sildenafil can lead to severe hypotension due to the vasodilatory effects of both medications. This is the most critical adverse reaction the nurse should anticipate.
B. Bradycardia is not a direct effect of this combination; rather, hypotension is a more significant concern.
C. Chest pain may occur if hypotension leads to inadequate perfusion, but it is not a direct adverse effect of the drug interaction.
D. Nausea can occur with various medications, but it is not specifically linked to the interaction between nitroglycerin and sildenafil.
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Correct Answer is B
Explanation
A. A drug that binds tightly to protein is typically released slowly, not quickly, as it remains bound in circulation.
B. Tight binding to proteins usually results in a prolonged duration of action since the drug is released gradually into the bloodstream, leading to sustained therapeutic effects.
C. Drugs that bind tightly to protein are generally not excreted quickly; they remain in circulation longer due to the binding.
D. While toxicity can occur with any drug, tight protein binding does not inherently lead to toxicity; it primarily affects the pharmacokinetics of the drug.
Correct Answer is A
Explanation
A. An INR of 5.0 indicates a significantly increased risk of bleeding, and administering vitamin K is the appropriate antidote for reversing the effects of warfarin. This is a critical intervention to restore coagulation.
B. Increasing the dose of warfarin is inappropriate in this scenario because the INR is already elevated; it would further increase bleeding risk.
C. While heparin can be used for anticoagulation, it is not appropriate to administer it while the INR is dangerously high without reversing the warfarin first.
D. Continuing warfarin is unsafe at this INR level due to the high risk of bleeding; monitoring for symptoms without intervention is not adequate care.