A nurse is reviewing the medication administration record (MAR) of a client who has hypertension. The nurse notices that the client has been prescribed both lisinopril and spironolactone. Which of the following actions should the nurse take?

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II, which causes vasoconstriction. Spironolactone is a potassium-sparing diuretic that lowers blood pressure by increasing urine output and preventing sodium and water reabsorption.

However, both medications can also increase potassium levels in the blood, which can lead to hyperkalemia, a potentially life-threatening condition. The nurse should hold both medications and notify the provider of this potential drug interaction.

Incorrect choices:

a) Administer both medications as ordered: This is incorrect as it exposes the client to the risk of hyperkalemia.

c) Hold lisinopril and administer spironolactone: This is incorrect as it does not eliminate the risk of hyperkalemia from spironolactone alone.

d) Hold spironolactone and administer lisinopril: This is incorrect as it does not eliminate the risk of hyperkalemia from lisinopril alone.

Prothrombin time (PT) is a measure of how long it takes for blood to clot. Warfarin is an anticoagulant that prolongs the PT and prevents blood clots from forming. The nurse should monitor the PT and adjust the warfarin dose accordingly to maintain a therapeutic range.

Incorrect choices:

b) Activated partial thromboplastin time (aPTT): aPTT is another measure of blood clotting time, but it is used to monitor heparin therapy, not warfarin therapy.

c) Platelet count: Platelet count is a measure of how many platelets are in the blood. Platelets are involved in blood clotting, but they are not affected by warfarin therapy.

d) Hemoglobin level: Hemoglobin level is a measure of how much oxygen-carrying protein is in the blood. Haemoglobin level can be affected by bleeding or anaemia, but it is not directly related to warfarin therapy.