Pharmacology Antihypertensives #5

Question

Before administering oral hydrochlorothiazide (HCTZ), what must the nurse assess for safe medication administration? Select all that apply.

Answers

  1. Intracranial pressure
    • Rationale:

      This answer is not correct because triamterene is an oral potassium sparing diuretic. Intravenous mannitol, an osmotic diuretic, is used to decrease intracranial pressure, if needed.

  2. HCTZ blood levels
    • Rationale:

      This answer is not correct because HCTZ does not have toxicity levels that need to be monitored. A common cardiac medication that has a toxicity level is digoxin.

  3. Hgb and Hct levels
    • Rationale:

      This answer is not correct because HCTZ is a thiazide diuretic and generally has no effect on Hgb or Hct levels. If the client is dehydrated, Hgb and Hct levels could be slightly elevated but it is unnecessary to check this before administration.

  4. Potassium levels
    • Rationale:

      This answer is correct because potassium levels can decrease with HCTZ therapy. Hypokalemia can cause cardiac arrhythmias and death so potassium levels should be monitored carefully.

  5. Blood pressure
    • Rationale:

      This answer is correct because HCTZ decreases fluid volume in the vascular system, which decreases blood pressure. Careful monitoring is imperative so the blood pressure does not become too low.

Overview

Hydrochlorothiazide is a thiazide diuretic which decreases fluid volume in the vascular system and lowers potassium levels. The client’s blood pressure and potassium levels need to be monitored closely.

Explanation

Learning Outcomes

Hydrochlorothiazide is a thiazide diuretic used as an antihypertensive medication. It is a potassium releasing diuretic, therefore it poses a risk for hypokalemia, which can cause an arrhythmia and subsequent death. Hypotension can become so great that organs can potentially not perfuse. This can cause end organ damage and death. The client should be close monitored for these two life threatening side effects.

Test Taking Tip

On a test day, eat a normal meal before going to school. If the test is late in the morning, take a high-powered snack with you to eat 20 minutes before the examination. The brain works best when it has the glucose necessary for cellular function.

Video Rationale