Phosphodiesterase 5 Inhibitors

Every question here, with the answer

1. A client took sildenafil last night and comes to the emergency department with chest pain. Which order should the nurse question?

   1. Obtain an ECG
   2. Check vital signs
   3. Apply oxygen as ordered
   4. Give sublingual nitroglycerin

   Answer: Give sublingual nitroglycerin

   Nitrates are contraindicated with PDE5 inhibitors, and clients should not take nitrates within 48 hours; together they can cause life-threatening hypotension and death. The other actions do not involve this interaction.

2. Which information should the nurse obtain before a client starts a PDE5 inhibitor? Select all that apply.

   1. Liver or renal disease
   2. Shoe size
   3. Use of nitrates
   4. History of heart attack, stroke or serious arrhythmias
   5. Use of alpha blockers

   Answer: Liver or renal disease, Use of nitrates, History of heart attack, stroke or serious arrhythmias, Use of alpha blockers

   The nurse reviews medications, especially nitrates and alpha blockers, and history of cardiovascular disease, prostate cancer, BPH and liver or renal disease. Shoe size is irrelevant.

3. A client asks if he can take a second dose of his PDE5 inhibitor later the same day if the first did not work. What should the nurse say?

   1. "Yes, but take it with nitroglycerin."
   2. "Yes, a second dose is always safe."
   3. "No, taking more than one dose in 24 hours can cause serious side effects."
   4. "Yes, as long as it is 4 hours later."

   Answer: "No, taking more than one dose in 24 hours can cause serious side effects."

   These drugs can cause serious side effects if taken incorrectly, such as more than one dose in 24 hours or with nitroglycerin. The other answers endorse unsafe use.

4. Which symptoms should a client taking a PDE5 inhibitor report immediately? Select all that apply.

   1. Mild flushing
   2. Sudden hearing loss
   3. Priapism
   4. Mild nasal congestion
   5. Sudden vision loss

   Answer: Sudden hearing loss, Priapism, Sudden vision loss

   Vision or hearing loss and priapism require immediate attention. Flushing and nasal congestion are listed common adverse effects.

5. A client takes an alpha blocker for blood pressure and asks for a PDE5 inhibitor. What does the nurse recognise?

   1. The alpha blocker makes the PDE5 inhibitor work faster.
   2. The combination is safe at any dose.
   3. The combination is contraindicated because it can cause life-threatening hypotension.
   4. The combination only causes mild headache.

   Answer: The combination is contraindicated because it can cause life-threatening hypotension.

   Concomitant use of nitrates or alpha-adrenergic blockers is a contraindication because the interaction can cause life-threatening hypotension and death. The other statements are not supported.

6. A client asks how his PDE5 inhibitor helps with erectile dysfunction. What is the best explanation?

   1. It stimulates sensory nerves directly.
   2. It blocks the PDE5 enzyme, relaxing blood vessels and increasing blood flow.
   3. It works for every cause of erectile dysfunction.
   4. It raises testosterone levels.

   Answer: It blocks the PDE5 enzyme, relaxing blood vessels and increasing blood flow.

   PDE5 inhibitors prevent the PDE5 enzyme from functioning, relaxing blood vessels and increasing blood flow. They do not raise testosterone and cannot be used for every cause of erectile dysfunction.