Page 1780 - Saunders Comprehensive Review For NCLEX-RN

5. Hypotension
6. Bradycardia
7. Impotence
8. Depression

C. Interventions

1. Monitor vital signs.
2. Instruct the client not to discontinue medication,
because abrupt withdrawal can cause severe rebound
hypertension.
3. Monitor liver function tests.
IX. Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin II
Receptor Blockers (ARBs) (Box 53-12)
A. Description
1. ACE inhibitors prevent peripheral vasoconstriction by
blocking conversion of angiotensin I to angiotensin II
(AII).
2. ARBs prevent peripheral vasoconstriction and
secretion of aldosterone and block the binding of AII
to type 1 AII receptors.
3. These medications are used to treat hypertension and
heart failure; also, ACE inhibitors are administered
for their cardioprotective effect after myocardial
infarction.
4. Avoid use with potassium supplements and
potassium-retaining (sparing) diuretics.

B. Side and adverse effects

1. Nausea, vomiting, diarrhea
2. Persistent dry cough (ACE inhibitors)
3. Hypotension
4. Hyperkalemia
5. Tachycardia
6. Headache
7. Dizziness, fatigue
8. Insomnia
9. Hypoglycemic reaction in the client with diabetes
mellitus
10. Bruising, petechiae, bleeding
11. Diminished taste (ACE inhibitors)

A persistent dry cough is a common complaint for those taking

an ACE inhibitor, but this often subsides after a few weeks. Instruct the
client to contact the PHCP if this occurs and persists.
C. Interventions

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