護理師正照護一位新開立口服 lisinopril 10 mg 每日一次的病人。該病人有血管性水腫病史。首要的護理考量為何？
A nurse is caring for a client with a new prescription for lisinopril 10 mg PO once daily. The client has a history of angioedema. What is the priority nursing consideration?
- AAssess for potential cough as a side effect.評估潛在的咳嗽副作用。
- BHold the medication and notify the physician due to the history of angioedema.✓ 正解因血管性水腫病史而暫停給藥並通知醫師。
- CMonitor for signs of hyperkalemia.監測高血鉀的跡象。
- DEducate the client about the importance of daily dosing.教育病人關於每日服藥的重要性。
血管收縮素轉換酶抑制劑（ACEI，如 lisinopril）具有誘發血管性水腫（angioedema）的副作用，此反應可能發生在用藥後數小時至數年。血管性水腫表現為臉部、嘴唇、舌頭及喉頭腫脹，嚴重時會導致呼吸道阻塞。由於病人已有相關病史，再次發生且演變為致命性呼吸道阻塞的風險極高，因此必須暫停並諮詢醫師改用其他降壓藥。
Angiotensin-converting enzyme inhibitors (ACEIs, such as lisinopril) carry a risk of inducing angioedema, which may occur anywhere from hours to years after starting therapy. Angioedema is characterized by swelling of the face, lips, tongue, and larynx, and can cause airway obstruction in severe cases. Because the client has a relevant history, the risk of a recurrent and potentially life-threatening airway obstruction is extremely high; the medication must therefore be withheld, and the physician should be consulted about switching to a different antihypertensive agent.