A nurse is reinforcing teaching with a client about how to prevent the onset of manifestations of Raynaud's phenomenon. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

A. “Your cholesterol levels should be monitored monthly while taking this medication”: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure and heart failure. It does not typically affect cholesterol levels, so monthly cholesterol monitoring is not usually necessary.

B. “Make sure your diet contains a lot of potassium-rich foods.”: While a balanced diet is important for overall health, patients taking lisinopril should be cautious about consuming too much potassium. Lisinopril can increase potassium levels in the body, and consuming too many potassium-rich foods could lead to hyperkalemia, a condition characterized by high levels of potassium in the blood.

C. “Monitor your blood pressure on a regular basis.”: This is correct. Since lisinopril is used to treat high blood pressure, it’s important for patients to monitor their blood pressure regularly to ensure the medication is working effectively.

D. “Notify your doctor immediately if you become pregnant.”: This is correct. Lisinopril is not recommended during pregnancy as it can harm the unborn baby. If a patient becomes pregnant while taking lisinopril, they should notify their doctor immediately.

E. “Report the development of a persistent dry cough.”: This is correct. A persistent dry cough is a common side effect of ACE inhibitors like lisinopril. If a patient develops this symptom, they should report it to their healthcare provider.

(A) Place the client in high-Fowler’s position and encourage the use of incentive spirometer and coughing: This is the most appropriate action. The high-Fowler’s position can help improve lung expansion and gas exchange, while the use of an incentive spirometer and coughing can help clear secretions and improve ventilation. This is particularly important for a client who is postoperative following an open thoracotomy.

(B) Switch oxygen to a nonrebreather mask: Switching to a nonrebreather mask may deliver a higher concentration of oxygen, but it does not address the underlying issue of impaired gas exchange due to decreased lung expansion and retained secretions.

(C) Position the client prone and have the respiratory therapist perform postural drainage: While postural drainage can help clear secretions, it may not be comfortable or safe for a client who is 1 day postoperative following an open thoracotomy.

(D) Increase oxygen to 70%: Increasing the oxygen concentration may improve the client’s oxygen saturation, but it does not address the underlying issue of impaired gas exchange due to decreased lung expansion and retained secretions. Furthermore, excessively high concentrations of oxygen can have harmful effects, such as oxygen toxicity or suppression of the respiratory drive in some clients.