The nurse teaches the patient receiving propranolol (Inderal) at home for management of ventricular arrhythmias to monitor what parameter?

Choice A rationale

Reassuring the client without addressing the persistent cough would not be appropriate as it may signal a need for a different medication. The ACE inhibitor captopril can cause a bothersome, persistent cough in some patients due to increased bradykinin levels.

Choice B rationale

Instructing the patient to stop the medication immediately is not advised without consulting the healthcare provider. While the cough is a known side effect, stopping the medication abruptly may lead to unmanaged hypertension.

Choice C rationale

Scheduling an appointment with the provider to discuss changing to an angiotensin II receptor blocker (ARB) is appropriate. ARBs do not typically cause a persistent cough, making them a suitable alternative for patients who experience this side effect with ACE inhibitors.

Choice D rationale

Instructing the patient to go to the emergency room immediately is unnecessary as the persistent cough is a common side effect of ACE inhibitors and not an emergency situation. Emergency action is warranted for symptoms of angioedema, such as swelling of the face or throat.

Choice A rationale

Increased jugular venous pressure is more commonly associated with right-sided heart failure, where blood backs up into the venous system.

Choice B rationale

Liver enlargement is also indicative of right-sided heart failure due to congestion of the liver blood vessels.

Choice C rationale

Increased pulse rate can occur in both left and right-sided heart failure but is not a specific indicator of worsening left-sided failure.

Choice D rationale

Increased crackles in lung fields indicate fluid accumulation in the lungs, a sign of worsening left-sided heart failure. Left-sided heart failure leads to pulmonary congestion due to inadequate pumping of blood from the left ventricle.