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 A

Explanation

Mannitol is an osmotic diuretic that increases urine output and decreases intracranial pressure and intraocular pressure. The nurse should check the urine output before giving the medication to ensure adequate renal function and prevent fluid overload and electrolyte imbalance. The normal urine output is 0.5 to 1 mL/kg/hr.

Choice B is wrong because checking the blood pressure is not specific to mannitol administration. Mannitol can cause hypotension or hypertension depending on the fluid status of the client, but this is not the priority action before giving the medication.

Choice C is wrong because checking the blood glucose is not relevant to mannitol administration. Mannitol does not affect blood glucose levels.

Choice D is wrong because checking the oxygen saturation is not related to mannitol administration. Mannitol does not affect oxygen saturation levels.

A. Serum potassium B. Serum calcium C. Serum albumin D. Serum glucose.

Correct Answer is A

Explanation

The nurse should monitor the client’s serum potassium level closely because furosemide is a loop diuretic that can cause hypokalemia, which increases the risk of cardiac arrhythmias and digitalis toxicity. The nurse should also monitor the client’s fluid status, blood pressure, and renal function.

Choice B is wrong because Serum calcium is wrong because furosemide does not affect calcium levels significantly. Calcium levels are more likely to be affected by thiazide diuretics, which can cause hypercalcemia.

Choice C is wrong because Serum albumin is wrong because furosemide does not affect albumin levels significantly. Albumin levels are more likely to be affected by liver disease, malnutrition, or nephrotic syndrome.

Choice D is wrong because Serum glucose is wrong because furosemide does not affect glucose levels significantly. Glucose levels are more likely to be affected by diabetes mellitus, corticosteroids, or stress.

Normal ranges for the laboratory values are:

• Serum potassium: 3.5-5.0 mEq/L

• Serum calcium: 8.5-10.5 mg/dL

• Serum albumin: 3.5-5.0 g/dL

• Serum glucose: 70-110 mg/dL

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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

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Correct Answer is A

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Correct Answer is A

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