,Definition 1 of 12
- "Monitor the blood pressure often."
- "Discontinue treatment if a cough develops."
- "Stop the medication if swelling of the mouth, lips, or face develops."
- "Have blood drawn for potassium levels 2 weeks after starting the medication."
- "Notify other prescribers of new ARB prescription."
- "Report lightheadedness or dizziness upon standing to the provider."
rationale: The risk for hypotension is increased with ARB use, therefore the client should be
educated on the signs and symptoms of a low blood pressure and the need to monitor blood
pressure often. The medication should be stopped if angioedema occurs, and the health care
provider should be notified.
Electrolyte levels of potassium, sodium, and chloride should be obtained 2 weeks after the start
of therapy and then periodically thereafter. ARBs may increase the effects of other medications
such as antihypertensives and lithium, dosages may need to be adjusted accordingly. A dry cough
may occur during treatment with ARBs; however, it is not necessary to discontinue the medication
because the cough usually resolves. There is no need to avoid the use of NSAIDs while taking an
ARB. Serum levels are not monitored with ARB use.
A client receiving chemotherapy develops bone marrow suppression. The nurse will
monitor for which thrombocytopenic effect? Select all that apply.
- Fatigue
- Pale skin
- Deep vein thrombosis
- Dizziness
- Melena
- Purpura
- Emboli
- Hematuria
Click to highlight the assessment findings that require immediate follow-up by the nurse.
1537: 70-year-old male client presents in Emergency Department with shortness of breath
while tree trimming an hour ago. The client states, "my heart feels like it's flip flopping."
Client has a past medical history of hypertension, for which he takes metoprolol 50 mg
daily. Client additionally states he has been urinating more frequently through the night
and he has had a dry cough for the past week.
Vital signs (VS): heart rate (HR) 118 beats per minute, blood pressure (BP)
138/88 mmH, oxygen saturation (SpOz) 92% on room air, by mouth (PO) temperature 98F
, (36.7°C). Clear lung sounds in all lung fields. Pulse irregular and +2. Capillary refill 2
seconds. Skin warm and dry. Alert and oriented.
Click to highlight the 3 orders the nurse would perform right away.
- Administer diltiazem 0.25 mg/kg IV
- Apply and titrate oxygen to maintain oxygen saturation =92%
- Bed rest with bathroom privileges
- Continuous cardiac monitoring
- Initiate IV access
- Insert indwelling urinary catheter
A client with hypertension is prescribed an angiotensin I receptor blocker
(ARB). Which instruction will the nurse provide about this medication? Select all that apply.
- "Monitor the blood pressure often."
- "Discontinue treatment if a cough develops."
- "Stop the medication if swelling of the mouth, lips, or face develops."
- "Have blood drawn for potassium levels 2 weeks after starting the medication."
- "Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) concurrently with this
medication."
- "Notify other prescribers of new ARB prescription."
- "Report lightheadedness or dizziness upon standing to the provider."
- "Serum levels will be drawn at least once a month to ensure therapeutic levels."
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