A nurse is educating a group of students on caring for clients who are receiving antihypertension medications. Which of the following medications should the nurse attribute to causing a rise in creatinine levels?

Rationale:

A. A transesophageal echocardiogram (TEE) is a specialized echocardiographic procedure that provides detailed images of the heart, including the atria and ventricles. It is particularly useful for detecting ventricular thrombi (blood clots) that may not be visualized as well with transthoracic echocardiography.

B. While an echocardiogram can provide information about heart function, including conduction problems, a TEE is not typically used specifically for this purpose.

C. Exercise tolerance is typically assessed through exercise stress testing or other exercise- related procedures, not with a TEE.

D. Blood flow to the distal extremities is not directly assessed with a TEE. This procedure primarily focuses on evaluating cardiac structure and function.

Rationale:

A. Captopril, an angiotensin-converting enzyme (ACE) inhibitor, can cause a rise in serum creatinine levels as a result of its effects on renal blood flow and glomerular filtration rate. It is important to monitor renal function regularly in patients receiving ACE inhibitors.

B. Clonidine, an alpha-2 adrenergic agonist, typically does not have a significant effect on creatinine levels.

C. Verapamil, a calcium channel blocker, typically does not have a significant effect on creatinine levels.

D. Hydralazine, a direct-acting vasodilator, typically does not have a significant effect on creatinine levels.