Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

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.

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.