Final answer:
The nurse should instruct a client taking enalapril to monitor for the adverse effect of a dry cough. This effect is common with ACE inhibitors and is likely due to the accumulation of bradykinin causing cough reflex sensitivity. Patients must be aware of this and other more serious risks such as fetal renal failure.
Step-by-step explanation:
When a client is receiving enalapril, which is an angiotensin converting enzyme (ACE) inhibitor, one of the adverse effects that the nurse should instruct the client to monitor for is a dry cough. This side effect is relatively common with ACE inhibitors such as enalapril, benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), and perindopril (Aceon).
The cause of the cough is believed to be related to the increase in the levels of bradykinin, a peptide that can promote inflammation and cause cough reflex sensitivity. ACE inhibitors are known to block the enzyme responsible for breaking down bradykinin, leading to its accumulation.
While a dry cough is not the only potential adverse effect of ACE inhibitors, it is one that requires attention since it can affect the patient's quality of life and may necessitate a change of medication. Other serious risks associated with the use of ACE inhibitors, particularly in pregnancy, include the potential for fetal renal failure and other abnormalities. It is important for clients to be fully informed about these risks and to communicate any new or worsening symptoms to their healthcare provider.