A patient taking lisinopril (Zestril) for heart failure reports a ...

[sabina]

A patient taking lisinopril (Zestril) for heart failure reports a nagging, nonproductive cough. What is the nurse's best first action?
 
  a. Ask the patient whether he or she has received the annual influenza vaccination.
  b. Ask the patient how much the cough is interfering with sleep or other activities.
  c. Document the report as the only action.
  d. Notify the prescriber immediately.

Question 2

A patient with heart failure asks the nurse why the antihypertensive drug enalopril (Vasotec) has been prescribed. What is the nurse's best response?
 
  a. Hypertension is the most common cause of heart failure.
  b. Lowering your blood pressure will allow your heart to pump more easily.
  c. This drug will decrease the amount of blood your heart has to pump, leading to less work for you heart.
  d. Enalopril will cause your heart to reestablish its normal electrical functions so that it works more effectively as a pump.

[Danny Ewald]

Answer to Question 1

B
Many conditions can cause a cough, but a dry, nonproductive cough is the most common side effect of lisinopril and all other ACE inhibitors. Coughs associated with pulmonary infections or worsening of heart failure are usually productive. After assessing the patient's issues with the cough, if the patient is uncomfortable or if the cough interferes with sleeping and other activities, report these problems to the prescriber.

Answer to Question 2

B
Decreasing blood pressure helps improve the heart's action as a pump and decreases the heart's workload. Diuretics are used to decrease blood volume. Enalopril is an angiotensin-converting enzyme (ACE) inhibitor that interferes with the transition of angiotensin I to angiotensin II. An-giotensin II is a potent vasoconstrictor that causes increased blood pressure and increased work-load for the heart.