The nurse is caring for a client in the clinic who takes captopril and ramipril for hypertension. The health care provider renews the client’s prescriptions and leaves the room. Which comment by the client would prompt the nurse to notify the health care provider immediately ?

  • “I am able to start walking longer at the gym without getting tired.”
  • “Occasionally I am slightly dizzy when standing, so I get up slowly.”
  • “I don’t get short of breath anymore now that my blood pressure is controlled.”
  • “I am going to my gynecologist tomorrow for my 12-week pregnancy checkup.”
Number 4 is correct.
Ramipril is a category C drug during the first trimester of pregnancy; it is a category D drug in the second and third trimesters. Captopril is a category D drug in pregnancy. The health care provider must be notified and the medications discontinued immediately. ACE inhibitor therapy may increase exercise tolerance in clients once hypertension is controlled. Dizziness upon standing is a common side effect of ACE inhibitors, and clients should be reminded to stand up slowly from a sitting position. Improved blood pressure control decreases shortness of breath in many clients.