Question

D.K. comes to the clinic with complaints of “dizzy spell and wheezing” His blood pressure is 86/50, pulse 46, and respirations 30. His acebutolol was stopped, and diltiazem, was ordered.

4. What are the nursing considerations and teaching for patients taking calcium channel blockers like diltiazem? Provide rationale for your answer

Answer 1

Ans) Nursing consideration and teaching for patients taking calcium channel blockers:

- Assessment of baseline data: electrocardiogram, heart rate, BP, renal and hepatic tests before therapy.

- I & O, daily weight, signs and symptoms of CHF, angina.

- Contraindicated in: clients with 3rd degree block of sick sinus syndrome.

- Caution in clients concurrently taking digoxin & beta-blocker

- IV: monitor for tachycardaia and hypotension

- Avoid grapefruit juice

Health teaching for taking Tab diltiazem:

- Advise patient to take medication as directed at the same time each day, even if feeling well. Take missed dose as soon as possible unless almost time for next dose; do not double doses. may need to be d/c gradually.

- Advise patient to avoid large amounts (6-8 glasses of grapejuice/day)

- Instruct patient on correct technique for monitoring pulse. Instruct patient to contact if HR < 60 bpm.

- Caution patient to change position slowly to minimize orthostatic hypotension.

- May cause dizziness/drowsiness, advise patient to avoid driving or other dangerous activities.

- Instruct patient on importance of maintain good dental hygiene & see dentist often for teeth cleaning to prevent tenderness, gum bleeding and ginigival hyperplasia.

- Instruct patient to avoid concurrent use of ETOH or OTC medication especially cough & cold meds without consulting health care provider.

- Advise patient to notify if irregular heartbeats, dyspnea, swelling of hands & feet, pronounced dizziness, nausea , constipation or hypotension occurs or if headache is severe or persistent.

- Caution patient to wear protective clothing & use sunscreen to prevent photosensitivity reaction.