Question

The client with hypertension has an order for lisinopril plus hydrochlorothiazide (HTCZ) (Zestorectic). Prior to his initial dose, the client should be taught to: A. Check his pulse rate daily B. Remain in bed for 3-4 hours after taking the initial dose C. Expect a drop in his cholesterol level within six weeks D. Increase his intake of folic-acid-rich food such as orange juice

Short answer

Answer: The most appropriate advice is to remain in bed for 3-4 hours after taking the initial dose to prevent orthostatic hypotension.

Step-by-step solution

Identify the drugs and their purpose

Lisinopril is an ACE inhibitor that primarily lowers blood pressure and reduces the risk of heart attack or stroke. Hydrochlorothiazide (HTCZ) is a diuretic that also helps to reduce blood pressure and prevent fluid retention. Their combination, called Zestoretic, is commonly prescribed to individuals with hypertension.

Evaluate the possible advice given in each option

A. Check his pulse rate daily: This is a useful action to monitor one's health, but it is not specifically related to the initial dose of lisinopril and HTCZ. B. Remain in bed for 3-4 hours after taking the initial dose: The combination of these medications might cause orthostatic hypotension, a drop in blood pressure when the person stands up suddenly. It is important for the client to be aware of this situation and not engage in sudden movements. C. Expect a drop in his cholesterol level within six weeks: Although it's possible that better blood pressure control may help to improve overall cardiovascular health, this isn't directly related to the initial dose of lisinopril and HTCZ. D. Increase his intake of folic-acid-rich food such as orange juice: Not directly related to the initial dose, and these medications do not have a specific interaction with folic acid.

Determine the most suitable advice for the client

Based on the analysis made, Option B is the most appropriate advice for the client to follow. The client should be cautious about potential orthostatic hypotension when starting lisinopril and hydrochlorothiazide, and remaining in bed for a few hours after taking the initial dose can help avoid sudden drops in blood pressure. Answer: B. Remain in bed for 3-4 hours after taking the initial dose