A client present with complaints of headaches and occasional chest pain relieved by rest. Two years prior the client suffered a myocardial infarction with placement of a stent in the right coronary artery. Physical exam reveals blood pressure 182/98, heart rate 112, respiratory rate 24, oxygen saturation 94% on room air, and temperature of 99 degrees Fahrenheit. Current medications include Nitrate patch 20mg applied once daily, Plavix (Clopidogrel Bisulfate) 75mg PO once daily, and Diovan (Valsartan) 80mg PO once daily. Which updated medication regimen from the APN would be most effective?
| Increase Diovan (Valsartan) to 160mg PO daily and add Lasix (Furosemide) 20mg PO BID. | |
| Change nitroglycerin dose to 2 inches ointment applied twice daily rotating between the left and right shoulder. | |
| Discontinue nitroglycerin patch a Diovan switching client over a 2 week period to Diltiazem (Cardizem) 120mgSR once daily . | |
| Adjust Nitroglycerin patch to 15 mg once daily for 12 hours applied in the morning and removed at night before bed and add Toprol XL (Metoprolol succinate) 100mg PO once daily |
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