The nurse is caring for a patient who presents with metabolic alkalosis. Upon assessing the patient, which clinical manifestation will the nurse expect to find?

Choice A reason: Holding medication if B-type natriuretic peptide (BNP) results are high is not a standard intervention when administering lisinopril. BNP levels are used to assess the severity of heart failure, but they do not directly influence the administration of lisinopril. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that helps manage heart failure by reducing blood pressure and decreasing the workload on the heart.

Choice B reason: Checking serum potassium and creatinine levels is crucial when administering lisinopril. Lisinopril can affect kidney function and electrolyte balance. It may cause hyperkalaemia (elevated potassium levels) and increase serum creatinine levels, indicating impaired kidney function. Regular monitoring of these parameters helps ensure the patient's safety and the effectiveness of the medication.

Choice C reason: Encouraging the patient to add salt substitute with all meals is not recommended for patients taking lisinopril. Many salt substitutes contain potassium chloride, which can further increase the risk of hyperkalaemia in patients on ACE inhibitors like lisinopril. This intervention could lead to dangerous electrolyte imbalances.

Choice D reason: Documenting the extent of vision changes every shift is not related to the administration of lisinopril. Vision changes are not a common side effect of this medication. This intervention may be more relevant for patients on medications known to affect vision, but it is not specific to lisinopril.

Choice A reason: Increasing vitamin D levels with regular sun exposure may be beneficial for overall health but is not specifically targeted at preventing flares and complications of SLE. SLE patients are often advised to avoid excessive sun exposure as it can trigger flares and exacerbate symptoms.

Choice B reason: Utilizing an evidence-based smoking cessation program is important for SLE patients, as smoking can worsen the symptoms and complications associated with the disease. Smoking has been linked to increased disease activity, higher risk of cardiovascular complications, and reduced effectiveness of certain medications in SLE patients. Quitting smoking can improve overall health outcomes and reduce the risk of flares and complications.

Choice C reason: Eliminating all gluten, dairy, and seed oils from the diet is not universally recommended for SLE patients. While some patients may have specific dietary triggers or intolerances, there is no broad evidence suggesting that such eliminations are necessary for all SLE patients. A balanced, nutritious diet tailored to the individual's needs is more appropriate.

Choice D reason: Avoiding the influenza, COVID, and shingles vaccines is not recommended for SLE patients. In fact, vaccinations can help prevent infections that could trigger SLE flares or complications. It is important for SLE patients to discuss their vaccination schedule with their healthcare provider to ensure they are appropriately protected.