A nurse is caring for a client who has been taking captopril for one year. Which of the following laboratory values should the nurse review? (Select all that apply.)

Choice A rationale Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors can inhibit the production of aldosterone, a hormone that regulates sodium and potassium balance. This can lead to potassium retention and hyperkalemia. Therefore, the nurse must monitor the client's serum potassium level, which normally ranges from 3.5 to 5.0 mEq/L, to detect this potentially dangerous electrolyte imbalance. Choice B rationale Captopril can impair renal function by affecting the glomerular filtration rate, especially in clients with preexisting kidney disease. The BUN (blood urea nitrogen) level is a measure of kidney function. An increase in BUN, a normal range is typically 7 to 20 mg/dL, can indicate a reduction in the kidney's ability to excrete waste products. Choice C rationale While agranulocytosis is a rare but serious side effect of captopril, it is not a routine monitoring parameter for a client taking the medication for one year. Agranulocytosis is typically seen early in treatment. A WBC with differential would be ordered if the client presented with signs of infection such as fever or sore throat. Choice D rationale Captopril does not have a direct effect on hemoglobin levels. Hemoglobin is a component of red blood cells, and its concentration is a measure of the blood's oxygen-carrying capacity. Hemoglobin levels are more closely associated with conditions like anemia or polycythemia. The nurse would not routinely review this value in a client taking captopril. Choice E rationale Captopril does not typically cause hyperglycemia or hypoglycemia. It has no direct pharmacological effect on insulin secretion, glucose metabolism, or pancreatic function. Therefore, monitoring the glucose level, which normally ranges from 70 to 100 mg/dL fasting, is not a standard lab review for a client taking captopril.