A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis?

Choice A reason: Taking this medication with food is not necessary, as lisinopril can be taken with or without food. Food does not affect the absorption or effectiveness of lisinopril.

Choice B reason: Facial swelling is not an expected effect of this medication, but a serious adverse reaction that indicates angioedema. Angioedema is a life-threatening condition that causes swelling of the face, tongue, throat, and airway. It requires immediate medical attention and discontinuation of lisinopril.

Choice C reason: Reporting a cough to the provider is an important instruction, as a cough is a common and annoying side effect of lisinopril. Lisinopril belongs to the class of angiotensin-converting enzyme (ACE) inhibitors, which can cause a dry, persistent, nonproductive cough. The cough may interfere with the client's quality of life and adherence to the medication. The provider may prescribe an alternative medication, such as an angiotensin II receptor blocker (ARB), to avoid the cough.

Choice D reason: Increasing the intake of potassium-rich foods is not advisable, as lisinopril can cause hyperkalemia (high potassium levels) due to decreased potassium excretion in the urine. Clients should monitor their potassium levels and avoid excessive intake of potassium supplements or foods, such as bananas, oranges, potatoes, and tomatoes.

Choice A reason: Ototoxicity is not a severe reaction to propranolol, but it may occur with some other medications, such as aminoglycosides, loop diuretics, or salicylates. Ototoxicity may damage the inner ear or the auditory nerve and cause hearing loss, tinnitus, or vertigo. The nurse should assess the client's medication history and monitor the client's hearing function.

Choice B reason: Hypokalemia is not a severe reaction to propranolol, but it may occur with some other medications, such as thiazide diuretics, corticosteroids, or insulin. Hypokalemia may cause muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should advise the client to eat foods rich in potassium, such as bananas, oranges, or potatoes, and to have regular blood tests to check the electrolyte levels.

Choice C reason: Tachycardia is not a severe reaction to propranolol, but it may be a sign of overdose, withdrawal, or rebound effect. Propranolol is a beta-blocker that lowers the heart rate and blood pressure by blocking the effects of epinephrine and norepinephrine. Propranolol may cause bradycardia, not tachycardia, as a side effect. The nurse should monitor the client's vital signs and advise the client to take the medication as prescribed and not to stop it abruptly.

Choice D reason: Postural hypotension is a severe reaction to propranolol, as it may cause dizziness, fainting, or falls. Postural hypotension occurs when the blood pressure drops significantly when the client changes position, such as from lying to sitting or standing. Propranolol may cause postural hypotension by reducing the vascular tone and the cardiac output. The nurse should instruct the client to change position slowly and to report any symptoms of postural hypotension to the provider.