A patient is taking ACEl enalapril Vasotec. The nurse understands that patients taking this type of drug for hypertension need to be monitored carefully for:

Choice A reason: Severe hypotension is associated with prerenal acute kidney injury, not postrenal. Prerenal acute kidney injury results from decreased blood flow to the kidneys due to conditions like severe hypotension, leading to reduced kidney perfusion.

Choice B reason: Acute tubular necrosis (ATN) is a form of intrinsic or intrarenal acute kidney injury, not postrenal. ATN is typically caused by prolonged ischemia or exposure to nephrotoxic agents, which directly damage the kidney tubules.

Choice C reason: Postrenal acute kidney injury is caused by an obstruction in the urinary tract that prevents urine from leaving the kidneys, leading to increased pressure and kidney damage. Bilateral kidney stones partially blocking the flow of urine can cause such an obstruction, leading to postrenal acute kidney injury.

Choice D reason: Glomerulonephritis is a type of intrinsic or intrarenal acute kidney injury, not postrenal. It involves inflammation and damage to the glomeruli, the filtering units within the kidneys, and is not typically caused by an obstruction in the urinary tract.

Choice A reason: Cirrhosis of the liver is the most common cause of portal hypertension. Cirrhosis involves the scarring of liver tissue, which obstructs blood flow through the liver and increases pressure in the portal vein. This increased pressure can lead to complications such as varices (enlarged veins) that can rupture and cause bleeding, such as vomiting blood (hematemesis). The liver's inability to properly manage blood flow due to scar tissue buildup is central to the development of portal hypertension.

Choice B reason: Left ventricular failure can lead to pulmonary hypertension (increased pressure in the pulmonary arteries) but is not a common cause of portal hypertension. Portal hypertension specifically refers to increased pressure in the portal vein system, which is most often due to liver disease. Left ventricular failure affects the heart and lungs, not the liver or its blood vessels, thus not leading to the observed condition of portal hypertension.

Choice C reason: Renal stenosis refers to the narrowing of the arteries that supply blood to the kidneys, which can lead to hypertension (high blood pressure) but not portal hypertension. Portal hypertension is related to the liver and its blood flow, not the renal arteries. Renal stenosis primarily causes problems in the kidney's function and systemic blood pressure rather than affecting the portal vein system.

Choice D reason: Thrombosis in the spleen can cause localized issues but is not a common cause of portal hypertension. Portal hypertension is typically related to liver conditions, such as cirrhosis, which affect the blood flow through the liver and portal vein system. Thrombosis in the spleen might complicate portal vein blood flow but is not a primary cause like liver cirrhosis is.