Question

a nurse is teaching a client who is starting to take diltiazem. which of the following statements should the nurse identify as an indication that the client understands the teaching?

\i will stop taking the medication if i get dizzy.\
\i should not drink orange juice while taking this medication.\
\i should expect to gain weight while taking this medication.\
\i will check my heart rate before i take the medication.\

Explanation:

Identify the drug class and action

Diltiazem is a calcium channel blocker (specifically a benzothiazepine) used to treat hypertension, angina, and certain cardiac arrhythmias (like atrial fibrillation). It acts by relaxing vascular smooth muscle and slowing cardiac conduction, which decreases blood pressure and heart rate.

Evaluate the clinical implications

Because diltiazem slows down the heart rate (negative chronotropic effect) and can cause bradycardia, it is a critical nursing priority to teach the client to monitor their pulse. Clients should be instructed to check their heart rate before taking each dose and to withhold the medication and contact their healthcare provider if the heart rate is below a specified threshold (typically 50 or 60 beats per minute).

Analyze the incorrect options

• "I will stop taking the medication if I get dizzy.": Abruptly stopping a calcium channel blocker can cause rebound hypertension or worsening angina. Dizziness is a potential side effect due to vasodilation, but the client should notify their provider rather than stopping the drug on their own.
• "I should not drink orange juice while taking this medication.": Grapefruit juice, not orange juice, is known to inhibit the CYP3A4 enzyme, which can increase diltiazem levels and toxicity risk.
• "I should expect to gain weight while taking this medication.": Unexplained rapid weight gain can indicate fluid retention or worsening heart failure, which is an adverse effect that must be reported, not a normal expectation.

Synthesize the correct client statement

The statement "I will check my heart rate before I take the medication." directly demonstrates that the client understands the necessity of monitoring for bradycardia, a major potential adverse effect of diltiazem therapy. This aligns with standard Nursing Assessment and patient safety protocols.

Answer:

• "I will stop taking the medication if I get dizzy."
• "I should not drink orange juice while taking this medication."
• "I should expect to gain weight while taking this medication."
• "I will check my heart rate before I take the medication." (Correct answer)