Which adverse effect of an angiotensin converting enzyme inhibitor (ACE inhibitor) will the nurse expect to assess in a hypertensive patient?

Choice A reason: This is not the agent that the nurse should question. Beta blockers are a class of medications that lower the blood pressure and heart rate by blocking the beta receptors in the heart and blood vessels. They can be used to treat hypertension, angina, heart failure, and arrhythmias. They do not cause edema or hyperkalemia.

Choice B reason: This is not the agent that the nurse should question. Alpha 2 agonists are a class of medications that lower the blood pressure by stimulating the alpha 2 receptors in the brain, which reduce the sympathetic nervous system activity. They can be used to treat hypertension, especially in patients with renal impairment. They do not cause edema or hyperkalemia.

Choice C reason: This is not the agent that the nurse should question. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias. They may cause edema, but not hyperkalemia.

Choice D reason: This is the agent that the nurse should question. Aldosterone antagonists are a class of medications that lower the blood pressure and reduce fluid retention by blocking the action of aldosterone, a hormone that regulates the sodium and potassium balance in the body. They can be used to treat hypertension and heart failure, especially in patients with low renin levels. However, they can cause hyperkalemia, which can be dangerous for the patient. The nurse should question the prescriber about the rationale for prescribing this agent and monitor the patient's potassium level closely.

Choice A reason: ACE inhibitors do not lower heart rate. They lower blood pressure by blocking the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor. Beta blockers are the drugs that lower heart rate and blood pressure.

Choice B reason: ACE inhibitors inhibit vasoconstriction. This is the correct statement that describes the action of these medications. By blocking the angiotensin II formation, they prevent the narrowing of the blood vessels and reduce the resistance to blood flow.

Choice C reason: ACE inhibitors do not increase aldosterone secretion. They decrease it. Aldosterone is a hormone that causes the kidneys to retain sodium and water, which increases blood volume and pressure. By blocking the angiotensin II formation, ACE inhibitors reduce the stimulation of aldosterone secretion and promote sodium and water excretion.

Choice D reason: ACE inhibitors do not promote sodium retention. They promote sodium excretion. As explained above, ACE inhibitors reduce the aldosterone secretion and prevent the kidneys from reabsorbing sodium and water. This lowers the blood volume and pressure.