The nurse is caring for a client who has been admitted for uncontrolled hypertension
When the health care provider orders a second antihypertensive drug for the client, the client asks the nurse why the health care provider ordered another drug instead of increasing the first drug. The nurse's response is based on which principles?
1. A second drug from the same class is added to prevent the dose of the first drug from being increased.
2. Adding a second drug may allow both drugs to be used at a lower dose.
3. The effect of two drugs from different classes may have a greater effect than two drugs from the same class.
4. Adding the second drug will result in the diminished response of the first drug, which will increase the effects.
5. It is important to counteract the increased dose with another drug to decrease the potential for adverse effects.
Correct Answer: 1,2,3
Rationale 1: Keeping both doses low and taking advantage of an additive effect reduces the potential for adverse effects.
Rationale 2: Keeping both doses low and taking advantage of an additive effect reduces the potential for adverse effects.
Rationale 3: The two drugs will affect different receptor site to achieve the same goal, resulting in a greater response but at lower doses.
Rationale 4: Adding a second drug that has an antagonistic effect will result in canceling out the therapeutic effects of the first drug.
Rationale 5: Adding a second drug within the same class or from another class will allow lower dosing, which will decrease the potential for adverse effects.
Global Rationale: Keeping both doses low and taking advantage of an additive effect reduces the potential for adverse effects. The two drugs will affect different receptor site to achieve the same goal, resulting in a greater response but at lower doses. Adding a second drug that has an antagonistic effect will result in canceling out the therapeutic effects of the first drug and also increase the potential for adverse effects.
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