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.

Using the same finger for each blood glucose test can cause pain, infection, and callus formation. The client should rotate the fingers and use different sites for each test.

Incorrect choices:

a) "I should check my blood glucose before meals and at bedtime.": This is correct as it follows the recommended frequency of SMBG for most clients with diabetes mellitus.

c) "I should wash my hands with soap and water before each test.": This is correct as it prevents contamination and ensures the accuracy of the test results.

d) "I should record my blood glucose results in a log book.": This is correct as it helps the client and the health care team to evaluate the effectiveness of the diabetes management plan.