The nurse auscultates a S4 heart sound during the morning assessment of a client. Which additional assessment data would correlate with this finding?

A. The client is retaining fluids and will need a fluid restriction: While fluid retention can occur with certain medications, the specific symptoms of tingling lips and edema suggest a different issue, making this option less relevant.

B. The client has developed an expected side effect of the medication: Tingling of the lips and lip edema are not typical expected side effects of losartan. This medication can cause side effects like dizziness or hypotension, but angioedema is a serious concern that can occur.

C. The client is experiencing angioedema and notifies the healthcare provider: This is the most appropriate interpretation of the symptoms. Angioedema is a potentially serious allergic reaction that can occur with medications such as losartan, which is an angiotensin II receptor blocker. Immediate notification of the healthcare provider is crucial for further evaluation and management.

D. The client will need to have the dose of the medication reduced: While reducing the dose might be considered in some cases of side effects, the symptoms described indicate a potentially severe reaction that requires immediate attention rather than simply adjusting the dosage.

A. 47-year-old male construction foreman who takes atenolol: Atenolol is a beta-blocker used for hypertension and does not typically contribute to folic acid deficiency. This client’s occupation and medication are not directly associated with folate deficiency.

B. 43-year-old female with Crohn's disease: This client is at high risk for folic acid deficiency due to the malabsorption issues commonly associated with Crohn's disease. Inflammatory bowel diseases can impair the absorption of nutrients, including folate, making this client the most likely candidate for folic acid deficiency.

C. 58-year-old male who smokes one pack of cigarettes per day: Smoking is associated with various health risks, but it does not directly correlate with folic acid deficiency. This client may face other health issues, but folate deficiency is not specifically indicated.

D. 23-year-old female who drinks a glass of wine with dinner: Moderate alcohol consumption may affect folate metabolism, but a single glass of wine is unlikely to cause a significant deficiency. Other factors would need to be considered for a diagnosis of folate deficiency.