Question

A client being treated with lisinopril (Zestril) develops a hacking cough. The nurse should tell the client to: A. Take half the dose to control the problem B. Take cough medication to control the problem C. Stop the medication D. Report the problem to the doctor

Short answer

Answer: D. Report the problem to the doctor

Step-by-step solution

Identifying the medication's side effect

The first step is to identify that a hacking cough can be a common side effect of lisinopril, which is an ACE inhibitor used for treating high blood pressure and heart failure.

Evaluate the given options

Now that we know the cough is related to the medication, let's evaluate each of the provided options: A. Taking half the dose may not properly address the side effect and can impact the effectiveness of the treatment. B. Taking cough medication may provide temporary relief, but it doesn't address the underlying issue, which is the side effect of lisinopril. C. Stopping the medication is not advised, as it can lead to a sudden increase in blood pressure and worsening of the client's condition. The client should consult with their doctor first. D. Reporting the problem to the doctor is the best option, as the doctor can assess the situation and decide if it is necessary to change the medication or make other adjustments.

Choose the correct answer

Based on the analysis, the correct answer is: D. Report the problem to the doctor

Key concepts

ACE inhibitor cough

One of the known side effects of ACE inhibitors, like lisinopril, is a persistent dry cough. This type of cough is not harmful but can be quite bothersome for patients. It arises because ACE inhibitors affect the metabolism of certain substances in the lungs, leading to irritation and cough.
While this cough is non-productive and typically not associated with other respiratory symptoms, it is important for patients to understand that this is a recognized side effect and not a sign of deteriorating health. In some cases, patients may need to switch to a different class of medication if the cough is intolerable. It's also worth noting that the cough may resolve on its own, even while continuing the medication.

• Report persistent coughs to healthcare providers.
• Recognize that cough may not be associated with other symptoms.
• Understand that medication change may be necessary if the cough is intolerable.

Medication side effect management

Managing medication side effects is an important aspect of ensuring a patient's comfort and adherence to their treatment plan. If a side effect becomes bothersome, healthcare providers often have strategies to alleviate the discomfort without compromising therapeutic outcomes.
For instance, a step-by-step approach can be adopted, such as:

Adjusting the Dose

Reducing the medication dose may sometimes minimize side effects, but this should only be done under a doctor's guidance to maintain the efficacy of the treatment.

Adding a Counteractive Medication

In some cases, an additional medication can be prescribed to manage the side effects while continuing the primary treatment.

Medication Substitution

If side effects cannot be managed effectively, switching to an alternative medication might be necessary. This decision must also be made by a healthcare professional.
Patients should not adjust their medication regimen without first consulting their healthcare provider, as this may lead to serious health consequences.

Patient education on medications

Patient education is crucial when it comes to the effective management of medications. Patients who are well-informed about their medications, including how to take them, their expected benefits, and possible side effects, are more likely to adhere to their treatment plans and achieve better health outcomes.
Effective patient education should encompass:

• The purpose and action of the medication.
• How and when to take the medication, as well as what to do if a dose is missed.
• Potential side effects and what steps to take if they occur.
• Lifestyle adjustments that can complement medication therapy.
• The importance of consistent communication with healthcare providers.

By understanding these facets of medication use, patients can become active participants in their own healthcare, ultimately leading to improved management of their conditions.