National Physical Therapy Examination (NPTE) Practice Exam

What potential side effect should a physical therapist assistant monitor for when assisting a patient with congestive heart failure who is on diuretics and calcium channel blockers?

1. Unstable blood pressure

2. Decreased electrolyte levels resulting in increased arrhythmias

3. Dizziness and orthostatic hypotension

4. Extreme fatigue

The correct answer is: Dizziness and orthostatic hypotension

When assisting a patient with congestive heart failure who is on diuretics and calcium channel blockers, monitoring for dizziness and orthostatic hypotension is particularly important due to the physiological effects these medications can have on blood pressure regulation. Diuretics promote the excretion of sodium and water, which can lead to a reduction in blood volume. This decrease in blood volume can contribute to lower blood pressure, especially when a patient transitions from sitting or lying down to standing. Calcium channel blockers can also have a vasodilatory effect, further lowering blood pressure. As a result, when patients stand up quickly, they may experience a significant drop in blood pressure (orthostatic hypotension), causing dizziness or lightheadedness. Recognizing these symptoms is critical because they can increase the risk of falls and other injuries, particularly in patients who already have compromised cardiovascular function due to congestive heart failure. Monitoring for dizziness and orthostatic hypotension will enable healthcare providers to intervene appropriately, adjusting therapy or providing support as needed to ensure patient safety during activities.