Hypertension Basics
What is the normal bp range?
<120/<80
What is the pharmacological classification that is used for first line treatment of Hypertension and heart failure
Diuretics
What labs should be monitored?
liver function-metabolism
kidney function-excreted
While taking an ace or an arb medication can effect potassium levels. Can it cause hypokalemia or hyperkalemia
Name a side effects of alpha and beta blockers include:
hypotension including orthostatic hypotension
dizziness
bradycardia
No matter what antihypertensive medication that is administered there is one common side effect (or risk of it)
hypotension including orthostatic hypotension
Which lab should be evaluated once started on a diuretic
Potassium
Loop and Thiazide Diuretic hypokalemia
Potassium sparing Diuretic hyperkalemia
If a patient wants to stop taking their calcium channel blocker the patient should be instructed to?
to let the provider know and decrease the drug gradually
What annoying side effect can occur if taking an ACE inhibitor?
persistent dry cough
what could happen to a person if they stop a beta blocker abruptly?
rebound hypertension
Name 2 lifestyle management changes that pts should apply with hypertension (and really anytime)
increase exercise
low sodium diet (healthy eating)
Stop smoking
decrease alcohol intake
How does diuretics help with hypertension
by removing fluid from the vascular system
How do we know we met therapeutic effects with calcium channel blockers
patient will have decreased blood pressure
Name 3 potassium rich foods?
Bananas
Melon
salt substitutes
potatoes (root vegetables)
avocados
oranges
green leafy vegetables
Alpha adrenergic agents cause what affect on vessels?(alpha 1 blocker & alpha 2 agonist)
vasodilation (which why it helps with hypertension)
When is medication management typically started for someone with an elevated BP
Stage 1 hypertension
During normal bp and prehypertension lifestyle changes should be applied
What side effects will be relieved if a patient is taking a diuretic for Heart Failure
Heart failure signs and symptoms
SOB
Edema
weight gain
crackles
increase pulse and respiratory rate
Heart failure is a side effect of Calcium Channel Blockers, what would you teach your patient about observing for this condition?
watch for signs and symptoms of heart faiure
Lung sounds with crackles
Shortness of Breath
edema
weight gain
increased respiratory rate
increased bp
intake and output not equal (more in than out)
If a patient is taking an ACE inhibitor and develops a dry cough what do you expect the provider to suggest?
Change medication to an ARB
Beta Blockers if not selective can cause which side effects?
Bronchoconstriction
heart failure
What three drug classifications can also be used for heart failure
Diuretic
Ace or ARB
Beta Blocker
The side effect of Ototoxicity could occur from which diuretic
Loop Diuretic (lasix)
Name 3 nursing considerations for calcium channel blockers
Monitor BP and vital signs
monitor for flushing (vasodilation)
no grapefruit
monitor for heart failure
monitor for peripheral edema
Which lab values would you monitor if taking an ACE or an ARB
kidney function (BUN and Creatinine)-excreted by the kidneys
Hypoglycemia (masking) can occur when patients are taking beta blockers. What are signs and symptoms of hypoglycemia
weakness
decreased loc
sweating
coma
confusion