Which of the following clients would the nurse question an order for labetalol 50 mg PO?

Choice A reason: Captopril is an ACE inhibitor, which means it blocks the enzyme that converts angiotensin I to angiotensin II, a hormone that constricts blood vessels and raises blood pressure. Captopril is used to treat high blood pressure, heart failure, diabetic kidney disease, and some types of heart attack. ¹

Choice B reason: Lisinopril is also an ACE inhibitor, with similar effects and uses as captopril. Lisinopril may be preferred over captopril because it has a longer duration of action and fewer side effects. ²

Choice C reason: Atenolol is not an ACE inhibitor, but a beta blocker, which means it blocks the receptors for adrenaline and noradrenaline, hormones that increase heart rate and blood pressure. Atenolol is used to treat high blood pressure, angina, irregular heartbeat, and prevent heart attack and stroke. ³

Choice D reason: Labetalol is also not an ACE inhibitor, but a combination of alpha and beta blocker, which means it blocks both the receptors for adrenaline and noradrenaline, and the receptors for angiotensin II. Labetalol is used to treat high blood pressure, especially in pregnancy and hypertensive emergencies.

Choice E reason: Ramipril is another ACE inhibitor, with similar effects and uses as captopril and lisinopril. Ramipril may have additional benefits in preventing cardiovascular events and kidney damage in high-risk patients..

Choice A reason: How to check apical heart rate is not a priority education for this client. Apical heart rate is the number of heartbeats per minute that can be heard at the apex of the heart. It can be used to monitor the effect of cardiac medications, such as atenolol or digoxin. This client is taking atenolol, but the nurse can check the client's radial pulse (at the wrist) instead of the apical pulse, unless there is a discrepancy or an irregular rhythm. The nurse should teach the client how to check their radial pulse and report any changes or symptoms.

Choice B reason: Signs and symptoms of hypothyroidism are not a priority education for this client. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy of the body. Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression. This client is not taking any medication that affects the thyroid function, and there is no evidence of hypothyroidism in the client's history or labs. The nurse should assess the client's thyroid function and teach the client about the signs and symptoms of thyroid disorders.

Choice C reason: Bleeding precautions are a priority education for this client. Bleeding precautions are measures to prevent or minimize bleeding in clients who are at risk of bleeding, such as those who are taking anticoagulants, have low platelets, or have bleeding disorders. This client is taking warfarin, an anticoagulant that increases the risk of bleeding.

Choice D reason: Increasing potassium rich foods in the diet is not a priority education for this client. Potassium is a mineral that helps regulate the fluid balance, nerve impulses, and muscle contractions in the body. Potassium levels can be affected by medications, such as diuretics, ACE inhibitors, or potassium supplements. This client is taking captopril, an ACE inhibitor that can increase the potassium level in the blood. The client's potassium level is normal (4.8 mmol/L), and there is no need to increase the intake of potassium rich foods, such as bananas, oranges, potatoes, tomatoes, or beans. The nurse should monitor the client's potassium level and teach the client about the signs and symptoms of high or low potassium, such as muscle weakness, cramps, irregular heartbeat, or numbness.