A patient with heart failure has a new order for captopril ...

[tth]

A patient with heart failure has a new order for captopril (Capoten) 12.5 mg PO. After administering the first dose and teaching the patient about the drug, which statement by the patient indicates that teaching has been effective?
 
  a. I will be sure to take the medication with food.
  b. I will need to eat more potassium-rich foods in my diet.
  c. I will call for help when I need to get up to use the bathroom.
  d. I will expect to feel more short of breath for the next few days.

Question 2

Which action should the nurse include in the plan of care when caring for a patient admitted with acute decompensated heart failure (ADHF) who is receiving nesiritide (Natrecor)?
 
  a. Monitor blood pressure frequently.
  b. Encourage patient to ambulate in room.
  c. Titrate nesiritide slowly before stopping.
  d. Teach patient about home use of the drug.

[Kingjoffery]

Answer to Question 1

ANS: C
Captopril can cause hypotension, especially after the initial dose, so it is important that the patient not get up out of bed without assistance until the nurse has had a chance to evaluate the effect of the first dose. The angiotensin-converting enzyme (ACE) inhibitors are potassium sparing, and the nurse should not teach the patient to purposely increase sources of dietary potassium. Increased shortness of breath is expected with the initiation of -adrenergic blocker therapy for heart failure, not for ACE inhibitor therapy. ACE inhibitors are best absorbed when taken an hour before eating.

Answer to Question 2

ANS: A
Nesiritide is a potent arterial and venous dilator, and the major adverse effect is hypotension. Because the patient is likely to have orthostatic hypotension, the patient should not be encouraged to ambulate. Nesiritide does not require titration and is used for ADHF but not in a home setting.

[tth]

Thanks for the timely response, appreciate it

[juliaf]

TYSM