What adverse effect should a nurse monitor for in a client taking enalapril for heart failure?

Enalapril is an ACE inhibitor commonly prescribed for heart failure and hypertension. One significant adverse effect associated with ACE inhibitors like enalapril is hyperkalemia, which is an elevated level of potassium in the blood. This can occur because ACE inhibitors block the production of angiotensin II, a substance that normally increases aldosterone secretion. Aldosterone promotes the excretion of potassium from the body, so when its levels decrease, potassium levels can rise significantly.

Monitoring for hyperkalemia is crucial for patients on enalapril due to the risk of serious cardiac complications, including arrhythmias, that can arise as potassium levels become dangerously high. Regular blood tests to monitor potassium levels are recommended for patients on this medication.

While bradycardia, loss of smell, and hypoglycemia can be adverse effects associated with other medications or conditions, they are not commonly related to the use of enalapril. Hence, hyperkalemia stands out as a specific and serious side effect that warrants careful monitoring in clients taking this drug for heart failure.