A client with a history of hypertension who was prescribed Captopril complains of a chronic dry cough for the past several weeks. Which of the following actions should the nurse recommend?
The client should report to an urgent care for potential hypokalemia.
The client should immediately use an epinephrine auto- injector (Epi-Pen) and call 9-1-1
The client should contact their provider, who may switch them to a different medication
The client should stop taking the Lisinopril immediately.
The Correct Answer is C
A. The client should report to an urgent care for potential hypokalemia:
While ACE inhibitors like Captopril can increase potassium levels (hyperkalemia) due to their effects on the renin-angiotensin-aldosterone system, they are not typically associated with hypokalemia. The client's complaint of a dry cough is a well-known side effect of ACE inhibitors, not an indication of low potassium levels. Therefore, the recommendation to seek urgent care for hypokalemia is not appropriate in this case.
B. The client should immediately use an epinephrine auto-injector (Epi-Pen) and call 9-1-1:
The use of an epinephrine auto-injector is specifically indicated for severe allergic reactions (anaphylaxis), which typically present with symptoms such as difficulty breathing, swelling of the throat, or anaphylactic shock. A chronic dry cough associated with the use of Captopril is not indicative of an allergic reaction, but rather a known adverse effect of ACE inhibitors. Therefore, this response is inappropriate for the situation described.
C. The client should contact their provider, who may switch them to a different medication:
A chronic dry cough is a common side effect of ACE inhibitors like Captopril, occurring in some individuals due to the accumulation of bradykinin. If the cough is bothersome, the best course of action is for the client to contact their healthcare provider. The provider may consider switching the patient to an angiotensin II receptor blocker (ARB), which does not typically cause this side effect. This is the most appropriate and safe action.
D. The client should stop taking the Lisinopril immediately:
Lisinopril is an ACE inhibitor, similar to Captopril, and shares the same potential side effects, including a chronic dry cough. However, the client should not stop taking their medication without consulting their healthcare provider. Discontinuing the medication abruptly can result in uncontrolled hypertension and other risks. The correct course of action is to contact the provider to discuss possible alternatives, not to stop the medication independently.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Having 2 RNs ensure the blood product is properly labeled and matches the client’s identification:
Two registered nurses must independently verify that the blood product matches the patient's identification and that it is properly labeled. This is a critical safety measure to prevent errors, such as mismatched blood transfusions, which can lead to severe complications like hemolytic reactions. Proper verification before administration is a standard safety protocol in blood transfusion procedures.
B) Ensuring that the client signed a consent form for receiving blood transfusions beforehand:
Obtaining informed consent is a vital legal and ethical step before administering a blood transfusion. The nurse must ensure that the patient understands the potential risks and benefits of the procedure and has signed a consent form prior to transfusion. Without consent, the transfusion cannot legally be performed. This is a key part of patient rights and nursing responsibilities.
C) Preparing a primary and secondary IV tubing:
For blood transfusions, only blood administration tubing should be used, which typically includes a filter to prevent the infusion of any debris or clots. Using regular IV tubing (primary and secondary) for blood administration is not recommended, as it may not have the necessary filter and could potentially introduce contaminants. Blood should always be administered with tubing specifically designed for that purpose.
D) Obtaining a bag of 0.9% sodium chloride:
Normal saline is typically used as the solution to flush the IV line before and after the transfusion. It is compatible with blood products and helps to prevent clotting or reactions in the line. This is an essential step to ensure safe and effective blood administration.
Correct Answer is C
Explanation
A. "Early ambulation can help keep your lungs expanded and prevent pneumonia":
This statement is correct. Early ambulation is beneficial for respiratory function as it helps to keep the lungs expanded, encouraging deeper breaths and better oxygenation. This can help prevent complications like pneumonia and atelectasis, which are common after surgery due to immobility and anesthesia.
B. "Early ambulation is one part of preventing blood clots from forming in your legs":
This statement is also correct. Early ambulation is an important measure in preventing deep vein thrombosis (DVT) and pulmonary embolism (PE), which are common postoperative complications. Movement and walking promote circulation, reducing the risk of blood clots forming in the legs.
C. "Early ambulation usually delays wound healing and increases the risk of wound infection":
This statement is incorrect. Early ambulation does not delay wound healing or increase the risk of infection. In fact, early movement can help improve circulation, which is crucial for wound healing and tissue repair. Gentle movement and ambulation typically have positive effects on wound healing by promoting blood flow to the surgical site. However, patients should avoid excessive strain or stress on the wound to prevent dehiscence or other complications.
D. "Early ambulation can help your bladder and bowels recover from the anesthesia":
This statement is correct. Early ambulation helps stimulate gastrointestinal and urinary systems, which may be sluggish after anesthesia. Walking can encourage the return of normal bowel and bladder function by promoting peristalsis and helping to prevent constipation or urinary retention, both of which can be common after surgery.
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