The nurse is caring for a patient who will begin taking captopril (Capoten) for hypertension. The nurse reviews the patient's laboratory test results and notes increased BUN and creatinine. Which action will the nurse take?
a. Administer the captopril and monitor vital signs.
b. Contact the provider to discuss changing to fosinopril (Monopril).
c. Obtain an order for intravenous fluids to improve urine output.
d. Request an order to add hydrochlorothiazide (HydroDIURIL).
ANS: B
Patients who have renal insufficiency will not require a decrease in dose with fosinopril, as they would with other angiotensin-converting enzyme (ACE) inhibitors. If captopril is given, it should be given in a reduced dose. Increased IV fluids are not indicated.
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