A nurse is about to administer the first dose of captopril (Capoten) to a client with hypertension. Which is the priority nursing intervention?
a. Take the client's apical pulse for 1 full minute before drug administration.
b. Place the client in Trendelenburg position to facilitate blood flow to the heart.
c. Educate the client to sit on the side of the bed for a few minutes before rising.
d. Instruct the client to drink 3 L of fluid daily when taking this medication.
C
Angiotensin-converting enzyme (ACE) inhibitors such as captopril can cause severe hypotension with initial use. The client should be instructed to rise slowly and sit on the side of the bed for a few minutes to prevent hypotension-induced falls. No indication is known for assessment of the apical pulse for 1 full minute before taking captopril. Placing the client in a Trendelenburg position is not indicated. In case of a precipitous drop in blood pressure, a modified Trendelenburg position may be used. Adequate fluid intake is necessary but is not the priority in this situation.
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