Question

A client has severe coronary artery disease (CAD) and hypertension. Which medication order should the nurse consult with the health care provider about that is contraindicated for a client with severe CAD?

a. Clonidine
b. Amiloride
c. Bumetanide
d. Methyldopa

Answer 1

Consultation with a health care provider is needed for a client with severe CAD and hypertension regarding the use of Methyldopa, which could exacerbate cardiac conditions such as bradycardia, a potential risk with this medication.

Step-by-step explanation:

The question is concerning a medication that is contraindicated for a client with severe Coronary Artery Disease (CAD) and hypertension. Among the options provided, Methyldopa (d) is the medication that warrants attention. Methyldopa is an anti-hypertensive medication that can affect the heart. Since the client has severe CAD, this medication might pose additional risks, like exacerbating the cardiac condition, especially given that medications like Methyldopa have been associated with bradycardia, which is a slower than normal heart rate.

In contrast, Clonidine (a), Amiloride (b), and Bumetanide (c) are less likely to exacerbate CAD directly. Clonidine is a centrally acting alpha-2 adrenergic agonist, Amiloride is a potassium-sparing diuretic, and Bumetanide is a loop diuretic, which primarily acts on the loop of Henle to inhibit the reabsorption of sodium and chloride, but should not have a direct adverse effect on CAD.