Which of the following diuretics would be contraindicated for a patient with ascites and liver cirrhosis?

Correct Answer: D

Rationale: The correct answer is D, Triamterene. Triamterene is a potassium-sparing diuretic, which can lead to hyperkalemia. Patients with liver cirrhosis often have impaired liver function, leading to decreased potassium excretion. Hyperkalemia can worsen in these patients and can be dangerous. Mannitol (A) is an osmotic diuretic, Hydrochlorothiazide (B) is a thiazide diuretic, and Ethacrynic acid (C) is a loop diuretic, all of which can be used in patients with liver cirrhosis and ascites, but Triamterene should be avoided due to the risk of hyperkalemia.

Correct Answer: D

Rationale: In the case of a patient with acute myocardial infarction and left ventricular failure, the most suitable route/method of administration for glyceryl trinitrate is a slow intravenous infusion (Option D). The rationale behind choosing slow intravenous infusion is that it provides a controlled and gradual delivery of the medication, allowing for a more sustained effect on the patient's condition. This is crucial in managing acute heart conditions like myocardial infarction, where precise dosing and continuous monitoring are essential. Sublingual administration (Option A) is not ideal in this situation because the patient is in the intensive care unit with a critical condition, and sublingual administration may not provide the rapid and consistent absorption needed for immediate effect. Oral administration (Option B) is also not preferred due to the delayed onset of action and potential variability in absorption, which is not suitable for a patient requiring prompt and precise treatment. Intravenous bolus injection (Option C) may lead to rapid fluctuations in blood levels of the medication, potentially causing adverse effects or inadequate therapeutic response in this critical condition. In an educational context, understanding the rationale behind the choice of medication administration route is crucial for healthcare professionals to make informed decisions in clinical practice. It highlights the importance of patient-specific factors, drug pharmacokinetics, and the need for individualized treatment strategies in managing cardiovascular emergencies.

Correct Answer: A

Rationale: In the treatment of cardiac shock, the drug of choice is Dopamine. Dopamine is a naturally occurring catecholamine that acts on adrenergic and dopaminergic receptors. In cardiac shock, dopamine is used to increase cardiac output by enhancing myocardial contractility and improving renal perfusion. Propranolol (Option B) is a beta-blocker that would not be appropriate in the treatment of cardiac shock as it decreases heart rate and contractility, which can worsen the condition. Phenoxybenzamine (Option C) is an alpha-blocker used in conditions like pheochromocytoma, not for cardiac shock. Metaraminol (Option D) is a sympathomimetic amine used for treating hypotension, but not specifically for cardiac shock. In an educational context, understanding the rationale behind the choice of dopamine in cardiac shock is crucial for healthcare professionals, especially those involved in emergency medicine or critical care. Knowing the pharmacological effects of dopamine on cardiac function and hemodynamics helps in making informed decisions during emergencies. It also highlights the importance of selecting the most appropriate drug based on the pathophysiology of the condition to achieve the best patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Wolff-Parkinson White (WPW) syndrome. Explanation of why C is correct: WPW syndrome involves an accessory electrical pathway in the heart that can lead to rapid heart rates and potentially dangerous arrhythmias. Calcium channel blockers can exacerbate this condition by slowing conduction through the atrioventricular node while the accessory pathway remains unaffected. This can increase the risk of arrhythmias and adverse cardiac events in patients with WPW syndrome. Explanation of why others are wrong: A) Hypertension: Calcium channel blockers are commonly used to treat hypertension, so it is not a contraindication for giving the client this drug. B) First degree AV block: This is a relatively mild conduction abnormality and not a contraindication to using calcium channel blockers in the context of arrhythmia treatment. D) Glaucoma: Calcium channel blockers can actually be used to treat certain types of glaucoma, so it is not a contraindication in this case. Educational context: Understanding contraindications to medications is crucial in healthcare to ensure patient safety and optimal treatment outcomes. In the context of cardiovascular drugs, such as calcium channel blockers, knowing contraindications like WPW syndrome can prevent potential harm and guide appropriate treatment decisions. Healthcare providers must carefully assess each patient's medical history and condition to make informed decisions regarding drug therapy.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) 120. The systolic blood pressure is the top number in a blood pressure reading and represents the pressure in the arteries when the heart beats and pumps blood out. A systolic blood pressure of 120 mmHg is within the normal range (typically considered 90-120 mmHg) for a healthy adult. Option A) 16 is the respiratory rate (RR) which measures the number of breaths a person takes per minute. Option C) 60 represents the diastolic blood pressure, which is the pressure in the arteries when the heart is at rest between beats. Option D) 99 is the oxygen saturation level, which indicates the percentage of hemoglobin binding sites in the bloodstream occupied by oxygen. Understanding vital signs is crucial in assessing a patient's overall health status. Knowledge of normal ranges and their significance helps healthcare providers identify potential issues or changes in a patient's condition. Monitoring vital signs like blood pressure is essential in diagnosing and managing various cardiovascular conditions. By correctly identifying the systolic blood pressure, healthcare professionals can make informed decisions regarding a patient's treatment and care.