An older adult patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for the older adult patient taking this class of drug?

Correct Answer: D

Rationale: The most concerning adverse effect for an older adult patient taking a vasodilator for hypertension is hypotension, which is abnormally low blood pressure. Older adults may be more sensitive to the blood pressure-lowering effects of vasodilators due to age-related changes in the cardiovascular system. Hypotension can lead to dizziness, lightheadedness, falls, and even fainting, increasing the risk of injury in older adults. Monitoring blood pressure regularly and adjusting the dosage appropriately are crucial in managing this potential adverse effect in older patients.

Correct Answer: B

Rationale: In a hypertensive emergency where a patient's blood pressure is extremely elevated (such as 270/150 mm Hg in this case), one of the medications commonly used is a titratable intravenous antihypertensive medication like nicardipine. The maximum dose of nicardipine that should be infused is typically guided by the patient's response to treatment and not a fixed duration of time. Therefore, the correct answer is B, as it highlights the importance of titrating the medication based on the patient's blood pressure response, rather than a specific time frame for infusion. Utilizing the drug at the lowest effective dose is crucial to avoid potential adverse effects, especially in a hypertensive emergency scenario.

Correct Answer: D

Rationale: Loop diuretics, such as furosemide and bumetanide, work by inhibiting the sodium-potassium-chloride co-transporter in the thick ascending loop of Henle in the kidney. This mechanism of action leads to a significant diuretic effect. Loop diuretics have a rapid onset of action, typically within 30 minutes of administration, and they cause rapid diuresis. This rapid onset and potent diuretic effect make loop diuretics effective in situations requiring rapid removal of excess fluid, such as heart failure exacerbation or acute pulmonary edema.

Correct Answer: B

Rationale: Angioedema is a potentially serious side effect of ACE inhibitors. It involves swelling of the deeper layers of the skin and submucosal tissues and can affect areas such as the face, lips, tongue, throat, and extremities. One of the key signs of angioedema is difficulty breathing, or dyspnea. Other signs may include swelling, itching, and hives. It is crucial for nurses to monitor patients taking ACE inhibitors for any signs of angioedema as it can rapidly progress and lead to airway compromise and respiratory distress. Prompt recognition and intervention are essential to prevent any serious complications.

Correct Answer: D

Rationale: A sudden increase in temperature in a client receiving Pentamidine IV for the treatment of Pneumocystis carinii is most likely an indication that the client has developed another infection. Pentamidine is an antiparasitic medication used to treat Pneumocystis carinii pneumonia in immunocompromised individuals such as those with HIV/AIDS. An increase in temperature could be a sign of a new or worsening infection, especially in patients who are already immunocompromised. It is important for the nurse to monitor the client closely for signs of infection and notify the healthcare provider if there are any concerning symptoms.