On initiating an ACE inhibitor for the first time, what patient safety instruction is essential?

• A. Instruct the patient not to get up without assistance.
• B. Take potassium supplements daily.
• C. Prepare for an immediate dry cough.
• D. Continue diuretics at the same dose.

Answer: (A)

Starting an ACE inhibitor can cause a rapid drop in blood pressure, especially with the first dose, leading to dizziness or fainting. The essential safety instruction is to avoid getting up quickly or to do so with assistance to prevent falls as the body adjusts to the medication. This risk is higher in people who are volume depleted or also taking diuretics, so advising patients to sit or lie down if they feel lightheaded and, when appropriate, to take the first dose at bedtime helps keep them safe.

Potassium supplementation is not routinely indicated and can dangerously raise potassium levels when combined with ACE inhibitors. A dry cough can occur with these drugs but is a recognizable side effect rather than a safety instruction. Continuing diuretics at the same dose may be adjusted in practice to reduce risk of hypotension, not because it’s the primary safety action required when initiating therapy.