Mark Ilescu is a 44-year-old client who has been diagnosed with primary hypertension. His medical history...

Mark Ilescu is a 44-year-old client who has been diagnosed with primary hypertension. His medical history includes type 1 diabetes mellitus, with early signs of nephropathy. He had a myocardial infarction 2 years ago and has been treated with a beta-blocker, metoprolol, since that time. He has been taking hydrochlorothiazide in addition to the beta-blocker to treat his hypertension. His blood pressure today is 138/92 mm Hg, which is consistent with the readings on his last three visits. His physician has added captopril to his treatment regimen.

Mark states that he does not understand why he needs an additional medication considering his blood pressure is below 140 mm Hg systolic. How should the nurse respond?
Discuss the rationale for choosing captopril in Mark’s case.
What should the nurse include in teaching Mark in order to minimize adverse effects of the captopril and metoprolol?

Expert Solution

Nurse response to Mark and rationale for using Captopril :

Captopril is angiotensin converting enzyme inhibitor. It is used in case of high blood pressure. In Mark's case, metoprolol and hydrothiazide is used to treat hypertension. Captopril is used to prevent strokes related to hypertension, heart attack and kidney problems. It also prevents kidney damage resulting from diabetes. Mark has type 1 diabetes and this is also a reason to include captopril in his medication regime. This should be explained by the nurse to Mark so that he understands the importance of captopril and continue with this medication.

How to minimize the adverse effects of metoprolol and captopril :

Take prescribed medication at regular time preferably after meals every day.
Avoid taking alcohol and smoking.
Drink lots of water to flush out the toxins.
As the body adjusts to captopril, there may be light headedness, dizziness and hence it is better to avoid driving at initial phase of taking medicine.
Check Blood pressure regularly.

These are the precautions that Mark has to take.

Thank you.

Nightingale answered 2 years ago

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