The nurse is caring for a patient who was recently placed on lisinopril to control hypertension. What teaching will the nurse provide?

Let your provider know if a new cough occurs

Take the medication on a full stomach

This medication will not cause edema

Eat a high potassium diet

Answer and Explanation

The Correct Answer is A

A. Let your provider know if a new cough occurs:
This teaching is essential because lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is associated with a potential side effect of a persistent, dry cough. Notifying the healthcare provider if a new cough develops allows for appropriate management, such as discontinuation or adjustment of the medication to alleviate the symptom.

B. Take the medication on a full stomach:
Taking lisinopril with or without food is acceptable, as it does not significantly affect its absorption. However, taking it on an empty stomach is often recommended to optimize absorption. Advising the patient to take the medication on a full stomach is incorrect and may lead to misunderstandings.

C. This medication will not cause edema:
Lisinopril, as an ACE inhibitor, may actually cause or exacerbate edema as a side effect. It can lead to vasodilation and fluid retention, particularly in susceptible individuals. Providing incorrect information about the medication's potential side effects can compromise patient understanding and safety.

D. Eat a high potassium diet:
Lisinopril can increase serum potassium levels, so instructing the patient to consume a high-potassium diet may exacerbate this effect and lead to hyperkalemia. While dietary potassium intake should be monitored, advising a high-potassium diet without proper guidance can pose risks to the patient's health.

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Correct Answer is A

Explanation

A. Human Immunodeficiency virus encephalopathy:
Human Immunodeficiency Virus (HIV) encephalopathy, also known as HIV-associated neurocognitive disorder (HAND), is a common neurological complication of HIV/AIDS. It occurs due to the direct effects of HIV on the central nervous system (CNS), leading to cognitive impairment, behavioral changes, and motor dysfunction. The progressive decline in cognitive, behavioral, and motor functions described in the patient is characteristic of HIV encephalopathy. Therefore, this choice is the most likely explanation for the patient's symptoms.

B. Beta-cell lymphoma:
Beta-cell lymphoma, also known as primary central nervous system lymphoma (PCNSL), is a rare but serious complication of HIV/AIDS. It involves the development of malignant lymphomas within the CNS. While PCNSL can cause neurological symptoms, such as cognitive decline and motor dysfunction, it typically presents with focal neurological deficits and signs of increased intracranial pressure, which are not mentioned in the scenario. Therefore, beta-cell lymphoma is less likely to be the cause of the patient's symptoms compared to HIV encephalopathy.

C. Kaposi sarcoma:
Kaposi sarcoma is a type of cancer caused by human herpesvirus 8 (HHV-8) infection, which commonly affects individuals with HIV/AIDS. While Kaposi sarcoma can involve the CNS and potentially lead to neurological symptoms, such as headaches and focal neurological deficits, the progressive decline in cognitive, behavioral, and motor functions described in the scenario is not typically associated with Kaposi sarcoma. Therefore, this choice is less likely to explain the patient's symptoms compared to HIV encephalopathy.

D. Wasting syndrome:
Wasting syndrome, also known as cachexia, is a syndrome characterized by unintentional weight loss, weakness, and muscle atrophy. While wasting syndrome is a common complication of advanced HIV/AIDS, it primarily affects body composition and nutritional status rather than causing progressive decline in cognitive, behavioral, and motor functions. Therefore, wasting syndrome is less likely to be the cause of the patient's symptoms compared to HIV encephalopathy.

A. Avoid using tobacco products B. Maintain normal body weight C. Control blood pressure D. Avoid eating foods high in fiber

Correct Answer is ["A","B","C"]

Explanation

A. Avoid using tobacco products: Tobacco use, including smoking and chewing tobacco, is a significant risk factor for atherosclerosis. Chemicals in tobacco smoke damage blood vessels, promote inflammation, and contribute to the development of plaque buildup in the arteries. Therefore, avoiding tobacco products is crucial for preventing atherosclerosis and reducing the risk of cardiovascular disease.

B. Maintain normal body weight: Obesity and excess body weight are associated with an increased risk of atherosclerosis and cardiovascular disease. Maintaining a healthy weight through a balanced diet and regular physical activity helps reduce the strain on the heart and blood vessels, lowers cholesterol levels, and improves overall cardiovascular health. Therefore, promoting weight management as part of atherosclerosis prevention is essential.

C. Control blood pressure: High blood pressure (hypertension) is a major risk factor for atherosclerosis and its complications, such as heart attack and stroke. Elevated blood pressure damages the inner lining of blood vessels, making them more susceptible to plaque buildup and narrowing. By controlling blood pressure through lifestyle modifications (such as a healthy diet, regular exercise, and stress management) and medications when necessary, individuals can reduce their risk of developing atherosclerosis and related cardiovascular events.

D. Avoid eating foods high in fiber: This statement is incorrect. Dietary fiber, found in fruits, vegetables, whole grains, and legumes, is beneficial for cardiovascular health. Fiber helps lower cholesterol levels, improve blood sugar control, and promote bowel regularity, all of which contribute to reducing the risk of atherosclerosis and cardiovascular disease. Therefore, consuming foods high in fiber is actually recommended as part of a heart-healthy diet and atherosclerosis prevention strategy.

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