A prescriber orders ramipril (Altace) for an obese patient with ...

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A prescriber orders ramipril (Altace) for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home.
 
  Which statement by the patient indicates understanding of the teaching?
  a. I am less likely to develop diabetic nephropathy when taking this medication.
  b. I should check my blood sugar more often, because hyperglycemia is a side effect of this drug.
  c. Taking this medication helps reduce my risk of stroke and heart attack.
  d. This medication will probably prevent the development of diabetic retinopathy.

Question 2

A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom?
 
  a. It indicates that a serious side effect has occurred.
  b. It is a common side effect that occurs in almost all patients taking the drug.
  c. It may be uncomfortable enough that the drug will need to be discontinued.
  d. It occurs frequently in patients taking the drug but will subside over time.

[Chou]

Answer to Question 1

ANS: C
Ramipril (Altace) is approved for reducing the risk of stroke and myocardial infarction (MI) in patients at high risk for a major cardiovascular event because they have hypertension in conjunction with a history of stroke or MI or because they have diabetes. ACE inhibitors cannot be used for primary prevention of diabetic nephropathy, but they can delay the onset of overt nephropathy in patients who already have less advanced nephropathy. ACE inhibitors do not affect serum electrolytes or glucose. One ACE inhibitor, enalapril, can reduce the risk of diabetic retinopathy in some patients with type 1 diabetes mellitus.

Answer to Question 2

ANS: C
A cough occurs in about 10 of patients taking ACE inhibitors and is the most common reason for discontinuing therapy. It does not indicate a serious condition. It occurs in about 10 of all patients and is more common in women, older adults, and those of Asian ancestry. It does not subside until the medication is discontinued.

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Thank you!

[Chou]

Always glad to help...