A client with a history of hypertension who was prescribed Captopril complains of a chronic dry cough for the past several weeks. Which of the following actions should the nurse recommend?

The client should report to an urgent care for potential hypokalemia.

The client should immediately use an epinephrine auto- injector (Epi-Pen) and call 9-1-1

The client should contact their provider, who may switch them to a different medication

The client should stop taking the Lisinopril immediately.

Answer and Explanation

The Correct Answer is C

A. The client should report to an urgent care for potential hypokalemia:
While ACE inhibitors like Captopril can increase potassium levels (hyperkalemia) due to their effects on the renin-angiotensin-aldosterone system, they are not typically associated with hypokalemia. The client's complaint of a dry cough is a well-known side effect of ACE inhibitors, not an indication of low potassium levels. Therefore, the recommendation to seek urgent care for hypokalemia is not appropriate in this case.

B. The client should immediately use an epinephrine auto-injector (Epi-Pen) and call 9-1-1:
The use of an epinephrine auto-injector is specifically indicated for severe allergic reactions (anaphylaxis), which typically present with symptoms such as difficulty breathing, swelling of the throat, or anaphylactic shock. A chronic dry cough associated with the use of Captopril is not indicative of an allergic reaction, but rather a known adverse effect of ACE inhibitors. Therefore, this response is inappropriate for the situation described.

C. The client should contact their provider, who may switch them to a different medication:
A chronic dry cough is a common side effect of ACE inhibitors like Captopril, occurring in some individuals due to the accumulation of bradykinin. If the cough is bothersome, the best course of action is for the client to contact their healthcare provider. The provider may consider switching the patient to an angiotensin II receptor blocker (ARB), which does not typically cause this side effect. This is the most appropriate and safe action.

D. The client should stop taking the Lisinopril immediately:
Lisinopril is an ACE inhibitor, similar to Captopril, and shares the same potential side effects, including a chronic dry cough. However, the client should not stop taking their medication without consulting their healthcare provider. Discontinuing the medication abruptly can result in uncontrolled hypertension and other risks. The correct course of action is to contact the provider to discuss possible alternatives, not to stop the medication independently.

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Correct Answer is C

Explanation

A. Intramuscular epinephrine:
Intramuscular epinephrine is typically used in cases of anaphylactic reactions, which present with symptoms such as difficulty breathing, swelling, hives, and hypotension. Flank and lower back pain are not typical signs of an anaphylactic reaction during a blood transfusion. Instead, flank pain may suggest a hemolytic reaction, which involves the destruction of red blood cells, not an allergic or anaphylactic response. Thus, epinephrine would not be the first-line treatment for this situation.

B. Intravenous corticosteroids:
Intravenous corticosteroids are often used for inflammatory reactions, such as in cases of autoimmune diseases or severe allergic reactions. While corticosteroids might be used for certain types of transfusion reactions, they are not the primary treatment for hemolytic reactions (which could cause flank and lower back pain). The primary goal in a transfusion reaction with flank pain is to manage potential hemolysis and prevent kidney damage, which would be addressed through hydration and other supportive measures.

C. High volume IV fluids:
High-volume IV fluids are the most appropriate immediate intervention for a client who is experiencing flank and lower back pain during a blood transfusion, which are signs of a potential hemolytic reaction. Hemolysis, or the breakdown of red blood cells, can lead to kidney injury, so increasing fluid volume helps flush the kidneys, promote diuresis, and reduce the risk of kidney damage. The fluids also help to dilute any hemoglobin that is released into the bloodstream, supporting the kidneys' ability to filter it out. This is the priority intervention in this scenario.

D. PO diphenhydramine:
Oral diphenhydramine is used for allergic reactions, such as mild reactions involving itching, rashes, or hives, but it is not appropriate for managing more severe transfusion reactions, such as hemolytic reactions, that cause flank and lower back pain. Diphenhydramine would not address the underlying issue of potential hemolysis and kidney injury. Therefore, it is not the correct intervention for this situation.

A. Aim to keep your HDL cholesterol as low as possible B. Controlling your diabetes is an important factor C. Exercising and achieving your goal weight are recommended D. Increase saturated fat intake and limit unsaturated fats E. It is important to keep your blood pressure within normal limits

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

Explanation

A) Aim to keep your HDL cholesterol as low as possible:
High-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream, thereby reducing the risk of atherosclerosis and coronary artery disease. The goal should be to raise HDL cholesterol levels, not lower them. Higher levels of HDL are associated with a lower risk of heart disease.

B) Controlling your diabetes is an important factor:
Diabetes is a major risk factor for coronary artery disease (CAD). Uncontrolled blood sugar levels can lead to damage of the blood vessels, increase the risk of atherosclerosis, and raise the likelihood of heart disease. Proper management of diabetes through diet, medication, and lifestyle changes is essential to reduce the risk of CAD.

C) Exercising and achieving your goal weight are recommended:
Regular exercise and maintaining a healthy weight are crucial for reducing the risk of coronary artery disease. Exercise helps improve cardiovascular health, lowers blood pressure, increases HDL cholesterol, and helps control body weight and blood sugar. Achieving and maintaining a healthy weight reduces the strain on the heart and lowers the risk of developing CAD.

D) Increase saturated fat intake and limit unsaturated fats:
Saturated fats can raise low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, which contributes to plaque buildup in the arteries and increases the risk of heart disease. Unsaturated fats, found in foods like olive oil, avocados, and fatty fish, are healthier and can help reduce cholesterol levels and improve heart health. The goal should be to limit saturated fats and increase the intake of unsaturated fats.

E) It is important to keep your blood pressure within normal limits:
High blood pressure is a significant risk factor for coronary artery disease. It can lead to the hardening and narrowing of the arteries, increasing the risk of heart attacks, strokes, and other cardiovascular events. Keeping blood pressure within normal limits through lifestyle changes, such as reducing salt intake, managing stress, exercising, and taking medications if needed, is essential for heart health.

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A client with a history of hypertension who was prescribed Captopril complains of a chronic dry cough for the past several weeks. Which of the following actions should the nurse recommend?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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

Explanation

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