A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?

Correct Answer: A

Rationale: A persistent dry cough is a common adverse effect of Enalapril, which is an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to cough. If the client experiences a persistent dry cough, it is essential to notify the healthcare provider for further evaluation and possible medication adjustment.

Correct Answer: D

Rationale: In the case of a client prescribed Metformin, monitoring serum creatinine levels is crucial to assess for potential adverse effects. Metformin is primarily excreted by the kidneys, so monitoring serum creatinine helps evaluate renal function. If renal impairment occurs, Metformin can accumulate in the body, leading to lactic acidosis, a serious adverse effect. Blood glucose monitoring (option A) is important in diabetes management but is not directly related to Metformin's adverse effects. Creatine kinase (option B) is an enzyme related to muscle damage, not specifically affected by Metformin. Hemoglobin A1c (option C) reflects long-term glucose control and is not a direct indicator of Metformin's adverse effects. In an educational context, understanding the rationale for monitoring specific laboratory values in relation to drug therapy enhances nursing practice. It reinforces the importance of individualized patient care, recognizing the significance of drug monitoring to prevent adverse reactions and ensure positive patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Avoid salt substitutes. Rationale: 1. **Avoiding Salt Substitutes**: Lisinopril is an ACE inhibitor that can cause hyperkalemia (high potassium levels). Salt substitutes often contain potassium chloride, so consuming them while on Lisinopril can elevate potassium levels to dangerous levels, leading to adverse effects such as arrhythmias. 2. **Why Others are Wrong**: - B) Taking Lisinopril at bedtime is not a specific instruction related to the medication's mechanism of action or potential side effects. - C) Increasing intake of potassium-rich foods is contraindicated as Lisinopril can already raise potassium levels. - D) Taking Lisinopril with food is generally acceptable, but it is not the most critical instruction compared to avoiding salt substitutes. 3. **Educational Context**: Educating patients about medication instructions is crucial to ensure optimal therapeutic outcomes and prevent potential harm. In the case of Lisinopril, emphasizing the importance of avoiding salt substitutes can help patients manage their potassium levels effectively and avoid complications. Pharmacology education plays a vital role in empowering patients to take an active role in their health management.

Correct Answer: A

Rationale: When a client is prescribed Prednisone, there is a risk of potassium depletion due to the medication. Therefore, it is essential to increase the intake of potassium-rich foods such as bananas, oranges, and spinach to help maintain adequate potassium levels in the body and prevent complications associated with low potassium levels.

Correct Answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments.