Question

The clinic nurse assesses a patient who takes Lisinopril (Prinivil) and a diuretic to control hypertension. The patient reports a dry, hacking cough that won't go away over the last several months. What action should the nurse take?

Select one:
a. Ask the patient if he has had a cold or flu recently.
b. Discuss the finding with the health care provider.
c. Ask the patient if he has been taking over the counter cold remedies.
d. Ask the patient if he is still taking the diuretic as ordered.

Answer 1

The nurse should discuss the patient's dry cough with the healthcare provider, as it is a known side effect of Lisinopril, an ACE inhibitor. Loop diuretics increase urination by inhibiting Na+ and Cl- reabsorption in the kidney's loop of Henle, which is directly related to their mechanism for lowering blood pressure.

Step-by-step explanation:

The patient's symptoms of a dry, hacking cough that has persisted for several months while taking Lisinopril (Prinivil) and a diuretic for hypertension suggest a potential side effect to the medication. Lisinopril belongs to a class of drugs known as ACE inhibitors which have a known side effect of causing a persistent dry cough in some patients. Given these facts, the most appropriate action for the nurse to take would be b. Discuss the finding with the health care provider. The health care provider can then consider the symptom in context with the patient's overall health status and medication regimen, and decide if the medication should be adjusted or changed.

Loop diuretics increase urination because they inhibit the reabsorption of Na+ and Cl- ions by the ascending limb of the loop of Henle in the kidney, which leads to more water being excreted. This follows the principle that 'where sodium goes, water follows', which is important in regulating blood pressure and can help to lower it when high.