Which risk is the nurse primarily concerned about for a patient newly diagnosed with stage 2 hypertension taking a thiazide and an ACE inhibitor?

The primary concern for a patient newly diagnosed with stage 2 hypertension who is taking a thiazide diuretic and an ACE inhibitor is postural hypotension and the potential for resulting injury. Thiazide diuretics can cause a decrease in blood volume and consequently a drop in blood pressure, especially upon standing. This phenomenon, known as postural or orthostatic hypotension, can lead to dizziness, lightheadedness, and an increased risk of falls and injuries when the patient changes positions, such as moving from lying down to standing up.

The combination of the diuretic, which manages fluid levels, and the ACE inhibitor, which helps with vascular resistance and lowers blood pressure, can heighten this risk. Monitoring the patient for symptoms of postural hypotension is critical, especially after initiating treatment or adjusting dosages, to ensure their safety.

Monitoring for rebound hypertension, sexual dysfunction, or any other side effects is also important, but the immediate concern with the treatment regimen in question centers on postural hypotension due to the mechanisms of the medications involved.