A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?

Choice A reason: Taking this medication with food is not necessary, as lisinopril can be taken with or without food. Food does not affect the absorption or effectiveness of lisinopril.

Choice B reason: Facial swelling is not an expected effect of this medication, but a serious adverse reaction that indicates angioedema. Angioedema is a life-threatening condition that causes swelling of the face, tongue, throat, and airway. It requires immediate medical attention and discontinuation of lisinopril.

Choice C reason: Reporting a cough to the provider is an important instruction, as a cough is a common and annoying side effect of lisinopril. Lisinopril belongs to the class of angiotensin-converting enzyme (ACE) inhibitors, which can cause a dry, persistent, nonproductive cough. The cough may interfere with the client's quality of life and adherence to the medication. The provider may prescribe an alternative medication, such as an angiotensin II receptor blocker (ARB), to avoid the cough.

Choice D reason: Increasing the intake of potassium-rich foods is not advisable, as lisinopril can cause hyperkalemia (high potassium levels) due to decreased potassium excretion in the urine. Clients should monitor their potassium levels and avoid excessive intake of potassium supplements or foods, such as bananas, oranges, potatoes, and tomatoes.

Choice A reason: This is incorrect because extravasation is not related to the lifetime cumulative dose limit of doxorubicin, but to the leakage of the medication from the vein into the surrounding tissue. Extravasation can cause severe tissue damage and necrosis, and should be prevented by using a central venous catheter and monitoring the infusion site.

Choice B reason: This is incorrect because red tinged urine and sweat are not related to the lifetime cumulative dose limit of doxorubicin, but to the normal excretion of the medication from the body. Red tinged urine and sweat are expected side effects of doxorubicin and do not indicate toxicity or harm.

Choice C reason: This is correct because an excess amount of doxorubicin can lead to cardiomyopathy, which is a serious and potentially fatal complication of the medication. Cardiomyopathy is a condition in which the heart muscle becomes weak and unable to pump blood effectively. The risk of cardiomyopathy increases with the cumulative lifetime dose of doxorubicin, which should not exceed 450 to 550 mg/m2.

Choice D reason: This is incorrect because myelosuppression is not related to the lifetime cumulative dose limit of doxorubicin, but to the dose-dependent effect of the medication on the bone marrow. Myelosuppression is a condition in which the production of blood cells is reduced, leading to anemia, leukopenia, and thrombocytopenia. Myelosuppression can be managed by adjusting the dose and frequency of doxorubicin and monitoring the blood counts.