A client with chronic heart failure developed an intractable cough and an incident of angioedema after starting enalapril. Which prescription does the nurse anticipate for this client?

Question

A client with chronic heart failure developed an intractable cough and an incident of angioedema after starting enalapril.  Which prescription does the nurse anticipate for this client?

Quizplus · Accepted Answer

Major side effects of angiotensin-converting enzyme (ACE) inhibitors include: Symptomatic hypotensionIntractable coughHyperkalemiaAngioedema (allergic reaction involving edema of the face and airways)Temporary increase in serum creatinine Symptomatic hypotension Intractable cough Hyperkalemia Angioedema (allergic reaction involving edema of the face and airways) Temporary increase in serum creatinine For clients unable to tolerate ACE inhibitors, angiotensin II receptor blockers (ARBs) such as valsartan or losartan are recommended. ARBs prevent the vasoconstrictor and aldosterone-secreting effects of angiotensin II by binding to the angiotensin II receptor sites. (Option A) Alprazolam is an anxiolytic. It is not used in the treatment of heart failure. (Option B) Dextromethorphan is a cough suppressant. A cough caused by an ACE inhibitor will not be improved by a cough suppressant. (Option C) Lisinopril is an ACE inhibitor. This client has been unable to tolerate this class of drug. Educational objective: ARBs are recommended for clients unable to tolerate ACE inhibitors.

A Client with Chronic Heart Failure Developed an Intractable Cough