一位病人剛獲開立 Lisinopril 處方。護理師應指導病人回報哪些副作用？（選所有適合的）
A nurse is caring for a client with a new prescription for Lisinopril. Which side effects should the nurse educate the client to report? (Select all that apply.)
- APersistent dry cough✓ 正解持續性乾咳
- BSwelling of the face or tongue✓ 正解臉部或舌頭腫脹
- CDizziness upon standing✓ 正解站起時頭暈
- DIncreased appetite食慾增加
- EElevated potassium levels✓ 正解血鉀升高
血管收縮素轉換酶抑制劑（ACEI）類藥物（如 Lisinopril）主要透過抑制 ACE 酵素，達到擴張血管與降低血壓的作用。此機轉同時會導致體內緩激肽（bradykinin）堆積，這是引發乾咳的主因。此外，ACEI 會抑制醛固酮（aldosterone）分泌，進而導致鉀離子滯留，增加高血鉀風險。血管性水腫（angioedema）雖罕見但屬致命性過敏反應，須立即停藥。姿勢性低血壓則是血管擴張後的常見藥物副作用。護理師應指導病人監測血壓、觀察水腫徵兆及定期抽血監測電解質。
Clients taking lisinopril should report a persistent dry cough, which results from bradykinin accumulation. They must also watch for signs of angioedema, such as facial or tongue swelling, which is a medical emergency. Additionally, clients should monitor for orthostatic hypotension and elevated potassium levels due to the drug's mechanism of action.
在美國臨床，針對服用 ACEI 的病人，藥師與護理師會強調監測「Dry cough」與「Angioedema」的重要性，因為這兩者是導致病人藥物順從性降低或發生急診的常見原因。台灣臨床做法類似，但更強調衛教高血鉀飲食限制。