A nurse is teaching a client who has a new prescription for captopril. Which of the following information should the nurse include in the teaching?
A.
“Take a daily potassium supplement. “
B.
“Monitor your pulse rate before taking medication.”
C.
“Increase the amount of sodium in your diet.”
D.
“Exercise caution when changing positions.”
The Correct answer and Explanation is:
The correct answer is:
D. “Exercise caution when changing positions.”
Explanation:
Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly prescribed for hypertension, heart failure, and other cardiovascular conditions. It works by relaxing blood vessels, making it easier for the heart to pump blood and lowering blood pressure.
When teaching a client about captopril, the nurse should emphasize the risk of orthostatic hypotension, a condition where blood pressure drops significantly when moving from a lying or sitting position to standing. This can cause dizziness, lightheadedness, and even fainting, especially during the initial stages of therapy or after an increase in dosage. Therefore, the client should be advised to change positions slowly to reduce the risk of falls or injury.
Option A: “Take a daily potassium supplement.”
This option is incorrect because captopril can increase potassium levels in the blood by reducing aldosterone production, which leads to potassium retention. Taking a potassium supplement could lead to hyperkalemia, a potentially dangerous condition where potassium levels become too high, causing cardiac arrhythmias or other serious complications. Clients should be instructed to avoid potassium supplements and potassium-rich foods unless directed otherwise by their healthcare provider.
Option B: “Monitor your pulse rate before taking medication.”
While some cardiovascular medications like beta-blockers require pulse monitoring due to their effect on heart rate, this instruction is less critical with ACE inhibitors like captopril. ACE inhibitors primarily lower blood pressure without directly affecting heart rate, so monitoring pulse isn’t as essential.
Option C: “Increase the amount of sodium in your diet.”
This is incorrect because sodium can increase blood pressure, counteracting the effect of captopril. Clients should generally be advised to reduce sodium intake to help control hypertension.
In conclusion, clients taking captopril should be taught to exercise caution when changing positions to avoid orthostatic hypotension, a common side effect of ACE inhibitors.