The nurse notifies the healthcare provider (HCP) that the client is having trouble remembering to take his second dose of captopril. What angiotensin-converting enzyme (ACE) inhibitors can be given only once per day? Select all that apply.

Choice A reason:

Shaking is lessened: This indicates that the client’s nervous system is stabilizing. Shaking or tremors can be a sign of an adverse drug reaction, particularly if the reaction involves the central nervous system. The lessening of shaking suggests that the adverse effects are subsiding and the client’s condition is improving.

Choice B reason:

Client is no longer flushed: Flushing is a common symptom of an adverse drug reaction, particularly with medications like vancomycin, which can cause “red man syndrome.” The absence of flushing indicates that the reaction is resolving and the client’s skin is returning to its normal state.

Choice C reason:

No longer itching: Itching is a common symptom of an allergic reaction. The cessation of itching suggests that the histamine response is diminishing, indicating that the adverse reaction is being controlled and the client is recovering.

Choice D reason:

Anxiety has decreased: Anxiety can be a symptom of an adverse drug reaction, particularly if the reaction involves the cardiovascular or nervous system. The decrease in anxiety indicates that the client’s overall condition is stabilizing and that the adverse effects are subsiding.

Choice E reason:

Skin warm and dry: Normal skin temperature and moisture levels indicate that the client’s autonomic nervous system is functioning properly. This is a positive sign that the adverse drug reaction is resolving and the client’s body is returning to its normal state.

Choice F reason:

Heart rate 62 beats/minute, blood pressure 130/72 mm Hg: These vital signs are within normal ranges for a resting adult. A normal heart rate (60-100 beats per minute) and blood pressure (less than 120/80 mm Hg) indicate that the client’s cardiovascular system is stabilizing and that the adverse drug reaction is resolving.

Choice G reason:

No chest pain noted: The absence of chest pain is a positive sign, as chest pain can be a symptom of a severe adverse drug reaction, particularly if it involves the cardiovascular system. The lack of chest pain indicates that the client’s condition is improving.

Choice H reason:

Respirations are even and unlabored: Normal respiratory function indicates that the client’s respiratory system is not being adversely affected by the drug reaction. Even and unlabored respirations suggest that the client is recovering and that the adverse effects are subsiding.

Choice I reason:

Drowsy: While drowsiness can be a side effect of medications like diphenhydramine, it can also indicate that the client’s body is relaxing and recovering from the adverse drug reaction. Drowsiness in this context is a sign that the client is stabilizing and that the adverse effects are being managed.

Choice A Reason:

Osteoarthritis is a common condition treated with NSAIDs like diclofenac. While it is important to monitor for potential side effects, osteoarthritis itself does not pose a significant concern in the context of diclofenac use. The medication is often prescribed to manage the pain and inflammation associated with osteoarthritis.

Choice B Reason:

Migraine headaches are also treated with NSAIDs, including diclofenac. While it is essential to monitor for side effects, migraines do not present a significant concern regarding the use of diclofenac. The medication can help alleviate the pain associated with migraines.

Choice C Reason:

Chronic alcoholism is of greatest concern when prescribing diclofenac. Alcohol can increase the risk of gastrointestinal bleeding and liver damage, both of which are potential side effects of NSAIDs. Combining alcohol with diclofenac can exacerbate these risks, making it crucial for the nurse to monitor the client closely and provide appropriate guidance.

Choice D Reason:

Type 2 diabetes mellitus requires careful management, but it is not the primary concern when prescribing diclofenac. While it is important to monitor for potential interactions and side effects, diabetes itself does not significantly increase the risks associated with diclofenac use compared to chronic alcoholism.