Which of the following clients would the nurse question an order for labetalol 50 mg PO?

Choice A reason: Captopril is an ACE inhibitor, which means it blocks the enzyme that converts angiotensin I to angiotensin II, a hormone that constricts blood vessels and raises blood pressure. Captopril is used to treat high blood pressure, heart failure, diabetic kidney disease, and some types of heart attack. ¹

Choice B reason: Lisinopril is also an ACE inhibitor, with similar effects and uses as captopril. Lisinopril may be preferred over captopril because it has a longer duration of action and fewer side effects. ²

Choice C reason: Atenolol is not an ACE inhibitor, but a beta blocker, which means it blocks the receptors for adrenaline and noradrenaline, hormones that increase heart rate and blood pressure. Atenolol is used to treat high blood pressure, angina, irregular heartbeat, and prevent heart attack and stroke. ³

Choice D reason: Labetalol is also not an ACE inhibitor, but a combination of alpha and beta blocker, which means it blocks both the receptors for adrenaline and noradrenaline, and the receptors for angiotensin II. Labetalol is used to treat high blood pressure, especially in pregnancy and hypertensive emergencies.

Choice E reason: Ramipril is another ACE inhibitor, with similar effects and uses as captopril and lisinopril. Ramipril may have additional benefits in preventing cardiovascular events and kidney damage in high-risk patients..

Choice A reason: This choice is incorrect because stomach distension and constipation are not common side effects of furosemide. They may be related to other causes, such as diet, fluid intake, or medication interactions. The nurse should assess the client's abdominal status and bowel habits and provide appropriate interventions, such as increasing fiber, fluids, or laxatives.

Choice B reason: This choice is incorrect because IV site irritation, redness, and pain are not specific side effects of furosemide. They may be caused by other factors, such as infection, infiltration, or phlebitis. The nurse should inspect the IV site and catheter and change them if needed. The nurse should also monitor the client's vital signs and blood cultures for signs of infection.

Choice C reason: This choice is correct because hearing loss or impairment is a rare but serious side effect of furosemide. It can occur due to damage to the inner ear or the auditory nerve. It may be temporary or permanent, depending on the dose and duration of furosemide therapy. The nurse should stop the infusion of furosemide and notify the provider immediately. The nurse should also assess the client's hearing and balance and provide safety measures.

Choice D reason: This choice is incorrect because frequent urination is an expected effect of furosemide. Furosemide is a diuretic that increases the excretion of water and electrolytes through the urine. It helps to reduce fluid overload and edema in clients with heart failure. The nurse should measure and record the client's intake and output and monitor the client's fluid and electrolyte status.