Question

A nurse is providing teaching to a client who has hypertension and a new prescription for Verapamil. Which of the following juices should the nurse instruct the client to avoid?

A) Orange juice.
B) Apple juice.
C) Grapefruit juice.
D) Cranberry juice.

Answer 1

The nurse should advise the client to avoid grapefruit juice while taking Verapamil due to the risk of increased medication levels and side effects. Overprescription of cardiac medications can result in bradycardia, and a patient with very low blood pressure requires immediate medical attention.

Step-by-step explanation:

The nurse should instruct the client with hypertension and a new prescription for Verapamil to avoid drinking grapefruit juice. Grapefruit juice affects the metabolism of certain medications, including Verapamil, by inhibiting the cytochrome P450 3A4 enzymes in the liver and intestinal wall. This inhibition can lead to increased levels of the medication in the bloodstream, which might increase the risk of side effects, such as bradycardia or hypotension. It's important for patients taking medications like Verapamil to be aware of this interaction to manage their hypertension effectively and safely.

Complications from overprescription of cardiac medications, such as beta blockers which block beta-1 receptors slowing heart rate (HR), can include bradycardia and potential stoppage of the heart. However, Verapamil is not a beta blocker but a calcium channel blocker, which works differently but can also lead to lowered heart rate and blood pressure when taken in excess or when its metabolism is affected by substances like grapefruit juice.

A patient with a blood pressure of 70/45, confusion, and complaints of thirst is likely experiencing hypotension and possible dehydration. The symptoms indicate the urgent need for medical evaluation and potential treatment for shock or other related conditions that could be causing the low blood pressure.