The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. Which is an adverse effect of this medication?
Constipation
Hypokalemia
Chronic cough
Nervousness
The Correct Answer is C
Choice A reason: This is not an adverse effect of ACE inhibitors. Constipation is a common side effect of opioid medications, which slow down the intestinal motility and cause hard stools.
Choice B reason: This is not an adverse effect of ACE inhibitors. Hypokalemia is a low level of potassium in the blood, which can be caused by diuretic medications, such as furosemide or hydrochlorothiazide, which increase the urine output and potassium excretion.
Choice C reason: This is an adverse effect of ACE inhibitors. Chronic cough is a dry, persistent cough that occurs in some patients taking ACE inhibitors, due to the accumulation of bradykinin, a substance that causes inflammation and irritation in the respiratory tract.
Choice D reason: This is not an adverse effect of ACE inhibitors. Nervousness is a common side effect of stimulant medications, such as caffeine or amphetamine, which increase the activity of the central nervous system and cause anxiety, agitation, and insomnia.
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Correct Answer is D
Explanation
Choice A reason: This is not the agent that the nurse should question. Beta blockers are a class of medications that lower the blood pressure and heart rate by blocking the beta receptors in the heart and blood vessels. They can be used to treat hypertension, angina, heart failure, and arrhythmias. They do not cause edema or hyperkalemia.
Choice B reason: This is not the agent that the nurse should question. Alpha 2 agonists are a class of medications that lower the blood pressure by stimulating the alpha 2 receptors in the brain, which reduce the sympathetic nervous system activity. They can be used to treat hypertension, especially in patients with renal impairment. They do not cause edema or hyperkalemia.
Choice C reason: This is not the agent that the nurse should question. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias. They may cause edema, but not hyperkalemia.
Choice D reason: This is the agent that the nurse should question. Aldosterone antagonists are a class of medications that lower the blood pressure and reduce fluid retention by blocking the action of aldosterone, a hormone that regulates the sodium and potassium balance in the body. They can be used to treat hypertension and heart failure, especially in patients with low renin levels. However, they can cause hyperkalemia, which can be dangerous for the patient. The nurse should question the prescriber about the rationale for prescribing this agent and monitor the patient's potassium level closely.
Correct Answer is C
Explanation
Choice A reason: This is not the best response by the nurse. Stopping the medication abruptly can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.
Choice B reason: This is not the best response by the nurse. Cutting the pill in half and taking a reduced dosage can affect the efficacy and safety of the medication. The patient should not change the dosage of the medication without consulting their health care provider.
Choice C reason: This is the best response by the nurse. Dizziness is a common side effect of ACE inhibitors, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.
Choice D reason: This is not the best response by the nurse. Scheduling the patient to visit the health care provider today is not necessary, unless the dizziness is severe, persistent, or accompanied by other symptoms, such as chest pain, fainting, or palpitations. The patient should be advised to monitor their blood pressure and report any significant changes or concerns to their health care provider.
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