A client reports feeling lightheaded and dizzy with palpitations after being instructed to increase the dose of a prescribed beta-adrenergic antagonist. How should the nurse respond to this client's symptoms?
Standard Text: Select all that apply.
1. "This is first-dose phenomenon."
2. "If the dose is increased again, take the medication at bedtime."
3. "This will go away in time."
4. "Maybe you have another health problem that needs to be examined."
5. "You may have taken too much medication."
Correct Answer: 1,2
Rationale 1: First-dose phenomenon is the onset of orthostatic hypotension when beginning or changing the dose of a beta-adrenergic antagonist.
Rationale 2: Taking the medication at bedtime will reduce the onset of first-dose phenomenon.
Rationale 3: Although this reaction may dissipate in time, this statement does not explain the cause of the client's symptoms.
Rationale 4: The client is experiencing first-dose phenomenon because of the increase in the dosage.
Rationale 5: The client was taking the prescribed increased dose of the medication.
Global Rationale: First-dose phenomenon is the onset of orthostatic hypotension when beginning or changing the dose of a beta-adrenergic antagonist. Taking the medication at bedtime will reduce the onset of first-dose phenomenon. Although this reaction may dissipate in time, this statement does not explain the cause of the client's symptoms. The symptoms the client is experiencing are consistent with the first-dose phenomenon of the prescribed medication dose.
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