A 49-year-old client is seen in clinic

A 49-year-old client is seen in clinic for a follow-up visit since starting enalapril for primary hypertension at her last visit 1 month ago. She reports nausea and diarrhea for the past few weeks and is not sure what is causing these symptoms because she has implemented various lifestyle changes. She has a medical history significant for dyslipidemia, which is treated with simvastatin, and type 2 diabetes mellitus, which is managed with insulin. Since her last visit, she has increased exercise, uses potassium supplements instead of sodium when cooking, and has eliminated alcohol. Vital signs are temperature of 98.6°F (37°C), heart rate of 80 beats per minute, respiratory rate of 20 breaths per minute, blood pressure of 126/78, and pulse oximetry reading of 97%.

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