What should a nurse monitor in a client receiving an ACE inhibitor like enalapril?

In a client receiving an ACE inhibitor such as enalapril, monitoring serum potassium levels is crucial due to the medication's mechanism of action and potential side effects. ACE inhibitors work by blocking the angiotensin-converting enzyme, which plays a vital role in the renin-angiotensin-aldosterone system. This action leads to vasodilation and a reduction in blood pressure. However, it also decreases aldosterone secretion, which can lead to increased retention of potassium by the kidneys.

Elevated serum potassium levels (hyperkalemia) can occur in patients taking ACE inhibitors, especially those with renal impairment, diabetes, or those who are taking potassium-sparing diuretics or dietary potassium supplements. Therefore, monitoring serum potassium levels helps ensure that they remain within a safe range to prevent serious complications, such as cardiac arrhythmias, which can be caused by hyperkalemia.

Monitoring blood glucose levels may be relevant in specific contexts, particularly for diabetic patients, but it is not a primary concern linked directly to the use of enalapril. Similarly, while heart rate and fluid intake are important parameters, they are not as directly affected by ACE inhibitors as potassium levels are.