A nurse is caring for a client who has heart failure and is receiving spironolactone (Aldactone). Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? (Select all that apply)

Captopril (Capoten) is an ACE inhibitor that can cause a dry, nonproductive cough as a side effect. This cough may be bothersome and interfere with the quality of life of the client.The client should inform the provider if this occurs, as the medication may need to be changed or adjusted.

Choice A is wrong because captopril should be taken one hour before meals, not with food.Food may decrease the absorption and effectiveness of the medication.

Choice B is wrong because captopril can cause hyperkalemia, or high levels of potassium in the blood, by decreasing aldosterone secretion.The client should avoid foods high in potassium, such as bananas, oranges, potatoes, and tomatoes, and have their potassium levels monitored regularly.

Choice D is wrong because captopril can cause hypotension, or low blood pressure, especially when the client first starts taking the medication or when the dose is increased.The client should take captopril in the morning or during the day, not at bedtime, to avoid orthostatic hypotension and falls.The client should also rise slowly from a sitting or lying position and report any symptoms of dizziness, lightheadedness, or fainting to the provider.

You should notify your provider if you experience weight gain. This is because weight gain can indicate fluid retention, which can worsen heart failure and cause more shortness of breath. Furosemide is a diuretic that helps reduce fluid overload, but it may not be enough to control the symptoms of heart failure. Therefore, the provider may need to adjust the dose or add another medication.

Choice A is wrong because you should not increase your intake of foods high in potassium. Furosemide can cause potassium loss, but increasing potassium intake can lead to hyperkalemia, which can affect the heart rhythm and function. You should follow the provider’s advice on how much potassium to consume and have your potassium levels checked regularly.

Choice B is wrong because you should not decrease your intake of fluids. Dehydration can cause low blood pressure, kidney damage, and electrolyte imbalance, which can also affect the heart. You should drink enough fluids to stay hydrated, but not too much to cause fluid overload. The provider may give you a specific amount of fluid to drink per day based on your condition.

Choice D is wrong because you should not take your medication with food. Furosemide is best absorbed on an empty stomach, and food can interfere with its effectiveness. You should take furosemide at least one hour before or two hours after meals.