Question

Barruch is a 50-year-old man who was given a prescription for lisinopril (Zestril) 1 month ago. While taking the medication, his systolic pressure has averaged between 130 and 138 mm Hg, and his diastolic pressure has averaged between 80 and 84 mm Hg. When he comes to the clinic today for follow-up, he states that he has a “dry cough” that “drives [him] crazy.” He has also noticed that he has been “catching every cold that comes along.” He would like to speak with the nurse about these complaints.
1. What does the nurse suspect is the cause of Barruch’s cough?

2. What does the nurse suspect is the cause of Barruch’s frequent infections?

Ayoub is a first-day postoperative patient who had an abdominal aortic aneurism repaired with a synthetic patch. He is sedated and is being monitored very closely to ensure his vital signs indicate adequate cardiac output and tissue perfusion, especially the kidneys.

3. Why would Ayoub have the vasodilator sodium nitroprusside (Nipride) being titrated in a continuous drip?

4. The family asks why this medicine is wrapped in aluminum foil. What is the nurse’s best response?

Answer 1

1.

Barruch's cough suspected by the nurse is because of side effects of lisinopril (ACE inhibitor). This is because the ACE inhibitors cause kidney issues (toxic products like Kinins are not excreted properly) which leads to accumulation of kinins in lungs, the cough is to spillout these kinins from the lungs.

2. The nurse may suspect the cause of Barruch's frequent infection is allergic rhinitis, this presents flue like symptoms. This is because the ACE inhibitors leads to hypersensitivity reactions like allergies rhinitis or angioedema as it's side effects.

3. Sodium nitroprusside is a potent vasodilator, it is used to reduce the arterial blood pressure to keep the blood vessel dilated and helps to reduce the morbidity.

To maintain the constant vasodilation by using sodium nitroprusside because this drug has the very short half life of only two minutes that is why there is continuous drip.

4. Because sodium nitroprusside is very sensitive to the light that is why the container is wrapped in aluminium foil. The family needs to be conveyed that the medicine is destroyed by light that is the reason behind covering it by aluminium foil.