For a client with a new prescription for the cholesterol medication gemfibrozil, the nurse instructs the client to immediately report what symptoms?

Choice A reason: This choice is correct because captopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause fetal harm or death if used during pregnancy. Captopril can affect the development of the baby's kidneys, lungs, skull, and blood vessels. The nurse should advise the patient to use effective contraception while taking captopril and to inform the provider as soon as possible if she becomes pregnant or plans to become pregnant. The provider may switch the patient to a safer medication for blood pressure control during pregnancy.

Choice B reason: This choice is incorrect because facial swelling is a serious side effect of captopril that may indicate angioedema, a life-threatening allergic reaction that causes swelling of the face, lips, tongue, throat, or airway. The nurse should instruct the patient to stop taking captopril and seek emergency medical attention if she develops facial swelling or any signs of difficulty breathing, such as wheezing, stridor, or cyanosis. Reducing the dose of captopril will not prevent or treat angioedema.

Choice C reason: This choice is incorrect because captopril can be taken with or without food, depending on the patient's preference and tolerance. Food may decrease the absorption of captopril, but this effect is not clinically significant for most patients. The nurse should advise the patient to take captopril at the same time each day, preferably one hour before meals, to maintain consistent blood levels and effects.

Choice D reason: This choice is incorrect because captopril is unlikely to cause anaphylaxis, a severe and potentially fatal allergic reaction that involves multiple organ systems. Anaphylaxis can cause symptoms such as hives, itching, flushing, swelling, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, fast heart rate, and shock. The nurse should instruct the patient to carry an epi pen only if she has a history of anaphylaxis or a severe allergy to another substance. .

Choice A reason: This is incorrect because spironolactone does not affect the heart rate. Checking the heart rate before each dose is not necessary.

Choice B reason: This is incorrect because spironolactone does not interact with acetaminophen. Taking acetaminophen with spironolactone will not cause bleeding.

Choice C reason: This is incorrect because spironolactone does not cause dry cough or increase blood sugar. These are not signs of adverse effects of spironolactone.

Choice D reason: This is correct because spironolactone can cause hyperkalemia, which is a high level of potassium in the blood. Bananas, cantaloupe, and spinach are high-potassium foods that should be avoided by clients taking spironolactone.