# A client who started lisinopril for hypertension reports swelling of the lips and tongue and difficulty swallowing. Which action should the nurse take first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393678&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client who started lisinopril for hypertension reports swelling of the lips and tongue and difficulty swallowing. Which action should the nurse take first?

## Option

1. Assess the airway, hold the medication, and notify the provider immediately. **✔ Correct answer**
2. Teach that a dry cough is an expected effect of lisinopril.
3. Advise the client to take the next dose with food.
4. Schedule a routine blood pressure check in one week.

**Correct answer: 1**

## Explanation

Lip and tongue swelling with dysphagia suggests angioedema, a serious adverse reaction associated with ACE inhibitors. Airway assessment and immediate provider notification are priorities, and the medication should be held. Dry cough is a common adverse effect, but it does not explain swelling and swallowing difficulty.

## In-depth explanation

Clinical Judgment
Airway symptoms from medication reactions override routine blood pressure follow-up.

Memory Tip
ACE inhibitor plus lips or tongue swelling equals airway risk.

KR vs US
NCLEX expects nurses to recognize adverse effects and stop unsafe medication administration.

## Clinical scenario

Clinical Practice Guide
ACE inhibitors can cause angioedema involving the lips, tongue, or airway. Suspected airway compromise requires urgent assessment and escalation.

Caution
Do not dismiss facial or tongue swelling as a minor allergy.

## Key concepts

- **Lisinopril** — An ACE inhibitor used for hypertension and heart failure; serious adverse effects can include angioedema.
- **Angioedema** — Rapid swelling of deeper skin or mucosal tissues that can threaten the airway when lips, tongue, or throat are involved.
- **Airway Assessment** — Immediate evaluation of breathing, voice, swallowing, tongue swelling, and signs of obstruction.

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