A nurse is teaching a client who has heart failure and is prescribed captopril. Which of the following instructions should the nurse include? (Select all that apply.).

Avoid salt substitutes that contain potassium.

Report any dry cough to the provider.

Take the medication on an empty stomach.

Drink at least 3 L of fluids per day.

Rise slowly from a sitting or lying position.

Answer and Explanation

Correct Answer : A,B,C,E

Captopril is an angiotensin-converting enzyme (ACE) inhibitor that is used to treat heart failure by lowering blood pressure and reducing the workload on the heart.

The nurse should include the following instructions when teaching a client who is prescribed captopril:

• Avoid salt substitutes that contain potassium. Captopril can increase the potassium levels in the blood, which can lead to hyperkalemia. Salt substitutes that contain potassium can further increase the risk of hyperkalemia, which can cause cardiac arrhythmias and muscle weakness.

• Report any dry cough to the provider. A dry cough is a common side effect of captopril and other ACE inhibitors. It is caused by the accumulation of bradykinin, a substance that dilates blood vessels and causes inflammation in the lungs.

The cough can be annoying and interfere with sleep and quality of life. The provider may switch the client to another type of medication if the cough is bothersome.

• Take the medication on an empty stomach. Food can decrease the absorption and effectiveness of captopril. The client should take the medication at least 1 hour before or 2 hours after meals.

• Rise slowly from a sitting or lying position. Captopril can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions.

This can lead to dizziness, fainting, and falls. The client should rise slowly and sit on the edge of the bed for a few minutes before standing up.

Choice D is wrong because drinking at least 3 L of fluids per day is not recommended for clients with heart failure.

Excessive fluid intake can worsen the symptoms of heart failure, such as edema, shortness of breath, and fatigue. The client should limit fluid intake to 2 L or less per day, unless instructed otherwise by the provider.

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Correct Answer is C

Explanation

Angiotensin II receptor blockers (ARBs) block the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects

Choice A is wrong because beta blockers do not block angiotensin II receptors, but rather beta-adrenergic receptors, which are involved in the sympathetic nervous system.Beta blockers reduce heart rate and blood pressure by inhibiting the effects of adrenaline and noradrenaline

Choice B is wrong because calcium channel blockers do not block angiotensin II receptors, but rather calcium channels, which are involved in the contraction of smooth muscle cells.Calcium channel blockers relax blood vessels and lower blood pressure by reducing the influx of calcium into the cells

Choice D is wrong because direct acting vasodilators do not block angiotensin II receptors, but rather act directly on the smooth muscle cells of blood vessels, causing them to relax and dilate.Direct acting vasodilators lower blood pressure by decreasing peripheral resistance

A. Beta blockers B. Calcium channel blockers C. Angiotensin II receptor blockers (ARBs) D. Direct acting vasodilators E. Adrenergic drugs.

Correct Answer is E

Explanation

Adrenergic drugs.These are drugs that stimulate the sympathetic nervous system by mimicking or enhancing the effects of epinephrine and norepinephrine, the chemical messengers that activate adrenergic receptors.Adrenergic drugs can increase blood pressure, heart rate, cardiac output, vascular tone, and renin release by acting on different types of adrenergic receptors.

Choice A is wrong because beta blockers are drugs that inhibit the sympathetic nervous system by blocking the beta adrenergic receptors, which are responsible for increasing heart rate and contractility. Beta blockers can lower blood pressure and reduce cardiac workload.

Choice B is wrong because calcium channel blockers are drugs that inhibit the movement of calcium ions across the cell membrane of smooth muscle cells, which are found in blood vessels and the heart.Calcium channel blockers can relax blood vessels and lower blood pressure, as well as reduce heart rate and contractility.

Choice C is wrong because angiotensin II receptor blockers (ARBs) are drugs that block the action of angiotensin II, a hormone that causes vasoconstriction and stimulates the release of aldosterone, which increases sodium and water retention.

ARBs can lower blood pressure by dilating blood

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A nurse is teaching a client who has heart failure and is prescribed captopril. Which of the following instructions should the nurse include? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which drug blocks the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects?

Correct Answer is C

Explanation

Which drugs act on the sympathetic nervous system, which regulates blood pressure by controlling heart rate, cardiac output, vascular tone, and renin release?

Correct Answer is E

Explanation

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