一位 55 歲高血壓病患服用 lisinopril。護理師在初次追蹤時應優先評估哪項發現？
A 55-year-old client with a history of hypertension is prescribed lisinopril. Which assessment finding should the nurse prioritize during the initial follow-up?
- AMild peripheral edema in the ankles腳踝輕微周邊水腫
- BReported fatigue after light exercise輕度運動後感到疲倦
- CPresence of a persistent dry cough✓ 正解持續性乾咳
- DBlood pressure reading of 130/80 mmHg血壓讀數為 130/80 mmHg
Lisinopril 屬於血管張力素轉換酶抑制劑（ACE inhibitors）。其最常見且具代表性的副作用是「持續性乾咳」，這是因為 ACE 抑制劑導致肺部激肽（Bradykinin）蓄積所致。此副作用雖然不危及生命，但會嚴重影響病人的生活品質與服藥順從性，護理師在追蹤時應優先評估並回報，以便醫師考慮更換為血管張力素受體阻斷劑（ARBs）。
Lisinopril belongs to the class of angiotensin-converting enzyme (ACE) inhibitors. Its most common and characteristic side effect is a persistent dry cough, caused by the accumulation of bradykinin in the lungs as a result of ACE inhibition. Although this side effect is not life-threatening, it can significantly affect the client's quality of life and medication adherence. The nurse should prioritize assessing and reporting this finding at follow-up, so the provider can consider switching to an angiotensin II receptor blocker (ARB).