RN Nursing · Antihypertensive Medications · Practice question
A nurse is educating a client who has diabetes mellitus and has been prescribed carvedilol for heart failure. Which of the following statements should the nurse include in the teaching? Select all that apply.
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"You should avoid eating foods high in calcium."
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✓
"You should monitor your blood sugar levels regularly."
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✓
"You should take this medication with food to reduce the risk of orthostatic hypotension."
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"You should avoid all physical activity while taking this medication."
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"You should expect to experience significant weight gain while taking this medication."
Answer & explanation
Correct: "You should monitor your blood sugar levels regularly." · "You should take this medication with food to reduce the risk of orthostatic hypotension."
Carvedilol is a non-selective beta-blocker and alpha-1 blocker used for heart failure. For a client with diabetes, two key teaching points are critical. First, blood sugar monitoring must be done regularly because carvedilol can mask the tachycardia that normally signals hypoglycemia; only diaphoresis will remain as a warning sign. This makes regular glucose monitoring essential so the client can detect hypoglycemia without relying on heart rate cues. Second, taking carvedilol with food is recommended because it slows absorption, which reduces the risk of orthostatic hypotension — a known adverse effect of this medication due to its alpha-blocking properties. Advising clients to avoid foods high in calcium is not a standard teaching point for carvedilol; calcium restrictions are relevant for certain renal conditions or medications like calcium channel blockers in specific contexts. Advising the client to avoid all physical activity is incorrect and potentially harmful; moderate exercise is often encouraged in heart failure management. Expecting significant weight gain is also inaccurate; modest fluid-related weight gain might occur if heart failure worsens, but carvedilol itself does not cause significant weight gain. The two correct statements are monitoring blood sugar and taking the medication with food.
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