The nurse is preparing to administer a calcium channel blocker to a client experiencing angina. Which mechanism of action makes this medication appropriate for this client?
1. It increases preload.
2. It has a positive inotropic effect.
3. It decreases afterload.
4. It has a positive chronotropic effect.
Correct Answer: 3
Rationale 1: Calcium channel blockers have little or no effect on preload.
Rationale 2: Some calcium channel blockers decrease contractility (negative inotropic effect).
Rationale 3: Calcium channel blockers cause arteriolar smooth muscle relaxation, leading to lowered peripheral resistance and decreased blood pressure (decreased afterload). This decreases myocardial oxygen demand and reduces frequency of anginal pain.
Rationale 4: Some calcium channel blockers lower heart rate (negative chronotropic effect).
Global Rationale: Calcium channel blockers cause arteriolar smooth muscle relaxation, leading to lowered peripheral resistance and decreased blood pressure (decreased afterload). This decreases myocardial oxygen demand and reduces frequency of anginal pain. Calcium channel blockers have little or no effect on preload. Some calcium channel blockers decrease contractility (negative inotropic effect). Some calcium channel blockers lower heart rate (negative chronotropic effect).
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