A patient with type 1 diabetes was prescribed a glucocorticoid for COPD. Which will the nurse expect in this patient?

Choice A reason: This is not an adverse effect of ACE inhibitors. Insomnia is a common side effect of stimulant medications, such as caffeine or amphetamine, which increase the activity of the central nervous system and cause difficulty falling or staying asleep.

Choice B reason: This is not an adverse effect of ACE inhibitors. Bradycardia is a slow heart rate, usually below 60 beats per minute. ACE inhibitors do not cause bradycardia, but rather lower the blood pressure by blocking the formation of angiotensin II, a potent vasoconstrictor.

Choice C reason: This is not an adverse effect of ACE inhibitors. Chest pain is a sign of angina or myocardial infarction, which are caused by reduced blood flow to the heart muscle. ACE inhibitors can actually prevent or treat these conditions by improving the blood flow and reducing the workload of the heart.

Choice D reason: This is an adverse effect of ACE inhibitors. Hyperkalemia is a high level of potassium in the blood, which can cause cardiac arrhythmias and muscle weakness. ACE inhibitors can cause hyperkalemia by reducing the secretion of aldosterone, a hormone that regulates the sodium and potassium balance in the body.

Choice A reason: Jugular vein distention is a sign of right-sided heart failure, not left-sided. It indicates increased pressure in the right atrium and vena cava.

Choice B reason: Peripheral edema is also a sign of right-sided heart failure, not left-sided. It indicates fluid retention in the lower extremities and abdomen.

Choice C reason: Decreased systemic vascular resistance is not a characteristic of left-sided heart failure. It is a compensatory mechanism that occurs in response to reduced cardiac output.

Choice D reason: Pulmonary congestion is a characteristic of left-sided heart failure. It indicates fluid accumulation in the lungs due to the inability of the left ventricle to pump blood effectively.