Question

G.G., a 72-year-old African-American woman, has heart failure (HF) and diabetes. Her vital signs are blood pressure 176/94; pulse 92; respirations 30. Her medications include hydrochlorothiazide, metoprolol, and digoxin. Why was hydrochlorothiazide prescribed for G.G.? Explain the effects of hydrochlorothiazide on blood pressure and why the blood glucose needs monitored. Abnormal electrolytes and other laboratory test results may occur when taking hydrochlorothiazide. Explain the imbalance. Would the following serum electrolyte and laboratory values be expected to increase, decrease, or unchanged? Sodium Potassium Calcium Magnesium Glucose Uric acid Cholesterol As the nurse, you review G.G’s current medication. What concerns do you identify and why? Explain your answer. When abruptly discontinuing beta blockers for hypertension without the client taking another antihypertensive, what might occur? Explain how adverse effects can be avoided. Explain the nursing considerations and teaching for patients taking beta blockers? G.G.'s blood glucose is 229. Her drugs for controlling hypertension are changed to prazosin. Her cholesterol and LDL are elevated. Her serum potassium level is 3.2 mEq/L. Why were G.G.'s hydrochlorothiazide and metoprolol discontinued and what type of antihypertensive is prazosin? Why was prazosin prescribed instead of other anti-hypertensive agents? Explain your answer. Explain the nursing considerations and teaching for this classification of medications (prazosin).

Answer 1

1) Hydrochlorothiazide is a thiazide diuretic, which is ma inly used to treat fluid retention and high blood pressure. In heart failure patients, the use of Hydrochlorothiazide helps to reduce the edema both pulmonary and peripheral edema.

2) Thiazide diuretics like hydrochlorothiazide must be used in optimal dose in order to achieve the antihypertensive effects. Many studies have proven that these drugs can effectively reduce the blood pressure like ther antihypertensives. However, use of hydrochlorothiazide may cause variations in electrolyte levels and blood glucose levels. Therefore, it is important to check the electrolyte levels and blood glucose levels while using thiazide diuretics. In this case, G. G. is already diabetic. So, it is imperative to manage the blood glucose levels in normal limits.