Diuretics
what is the action, uses, SE, and teachings of thiazide diuretics
give an example
Action: works in distal tubules to increase renal exretions (not as strong as loops)
Uses: HTN, edema
SE: dec. sodium, dec. Cl, dehydration, dec. BP, ortho hypotension, dec. K
Teachings: need adequate kidney function!!!!, gradual position change, K diet sources, monitor for edema (weights)
EX: HCTZ Metolazone
give an example
action: prevent conversion of angiotensin I to II, increased bradykini (vasodilator) - angioedema comes from here
uses: HTN, HF, MI, Nephropathy, prevent MI and stroke
Teaching: NSAIDs decreases effectiveness, diureitc enhance drug effects, teach to report dry cough
SE: hypotension, increased K, renal failure, fetal injury, cough = first sign of angioedema, angioedema - lifethreatening
"prils"
lisinopril
captopril
what is the action, uses, SE, and teachings for calcium channel blockers
give an example
action: SELECTIVE - in vessels cause vasodilation, in heart caused decreased HR contractility and conduction
uses: HTN, angina, arrhythmia, depends which CCB you pick
SE: bradycardia, exacerbation of HF, heart block, vasodilation may cause: dizziness, HA, edema
teaching: may cause reflex tachy and intensify the effect of beta blockers or digoxin, monitor chest pain, edema, BP, daily weights
examples:amlodipine, verapamil
what do alpha blockers do, SE, examples of
alpha blocker "osin" stop the effect of sympathetic nervous system on vessels that cause vasoconstriction
- these drugs vasodilate, can be used for urinary smooth muscle to treat BPH
side effects: can be excess effect, orthostatic hypotension (vein effect), reflex tachy, or blockage of sympathetic symptoms in other places - nasal congestion, impotence
examples - tamsulOSIN (Flomax), terazOSIN, DoxazOSIN
A patient is started on lisinopril for hypertension. Which of the following lab values should the nurse monitor most closely?
A. Sodium
B. Chloride
C. Potassium
D. Hemoglobin
✅ Answer: C. Potassium
💡 Rationale:
ACE inhibitors can cause hyperkalemia because they block aldosterone (the “keep sodium, ditch potassium” hormone). Think of it like your kidneys suddenly becoming chill with potassium hangin' around too long. 🔥🍌
what is the action, use, SE, and teachings for loop diuretics
give an example
Action: blookc reabsorption of Na and Cl in LOOP OF HENLE to prevent passive reabsorption (can reduce ECF volume and venous return to heart)
Uses: HF, Edema, Hepatic, Renal, HTN - that cannot be controlled with thiazide
SE: dec. sodium, dec. Cl, dec. K (muscle weakness, arrythmias), OTOTOXICITY (periodic deafness), orthostatic hypotension
Teaching: gradual position changes, K diet sources, BP and weight control, s/sx of electrolyte imbalances
EX: furosemide (Lasix) or Bumetanide (Bumex)
what is the action, use, SE and teaching of ARBs
give an example
action is similar to ACE - prevent aciton of A II, these meds produce vasodilation and excretion of salt and water
effects similar to ACEI but delayed effect and less angiodema
"sartans"
explain the part calcium has in our body
it is a big part of the "on switch" for the contraction of cells in the heart and arteries (selective)
what do betablockers do, SE, treat, and teachings
examples
beta blockers "olol" stop the effect of the sympathetic nervous system that tells the CV system to "work harder, work faster and vasoconstrict" and beta receptors in kidney --> renin release, selective classes
treats HTN, angina, dysrhythmias, MI, HF
SE: bradycardia, reduced conduction, contractility, cardiac output or blockage of sympathetic symptoms in other places
Teachings: careful with use in asthma (crosses over with albuterol - works on beta 2 but can cross over to beta 1), HF, and DM
Which statement by the patient taking atenolol indicates a need for further teaching?
A. "I will check my pulse before taking this medication."
B. "I might feel tired while adjusting to this drug."
C. "I should stop the medication if I feel better."
D. "I will report shortness of breath to my provider."
✅ Answer: C. "I should stop the medication if I feel better."
💡 Rationale:
Beta blockers aren’t like annoying friends—you can’t ghost them. Suddenly stopping can cause rebound hypertension or angina. Teach patients to wean off safely with provider guidance. 🚫💔
what is the action, use, SE, and teachings of potassium sparing diuretics
give an example
Action: blocks action of aldosterone in nephron, so increase Na excretion and increased K absorption
Uses: HTN or edema (often in combo with loop or thiazide diuretic), HF, Cirrhosis, hyperaldosteronism - from adrenal problems
SE: increased K, endocrine effects (steroid derivative - gynecomastia: enlarged male breast tissue , impotence, menstrual irrigation, hirsutism: women have hair, deepening of the voice ), N/V
Teachings: effects are delayed, never combine with K supplements (including salt subtitutes)
EX: spironolactone
A nurse is reviewing a new prescription for lisinopril with a patient who has hypertension. Which of the following statements by the patient indicates a need for further teaching?
A. "I will rise slowly from bed to avoid dizziness."
B. "I should avoid using salt substitutes with potassium."
C. "I might develop a dry cough while taking this medication."
D. "If I miss a dose, I can double the next one."
✅ Answer: D. "If I miss a dose, I can double the next one."
💡 Rationale:
Never double up on ACEIs like they're buy-one-get-one-free tacos. Doubling the dose increases risk for hypotension and other side effects. Always take as prescribed, even if you forget a dose.
if we turn off (or turn down) the swithc for CCBs what can it do for our body
1. dilate arteries (tx HTN, angina)
2. decrease force of cardiac contraction
3. slow HR
4. treat arrhythmias
5. decrease conduction through AV node
What are some examples of adrenergic blockers and what do they do
alpha = tamsulosin (flomax)
beta = propranolol, metoprolol (lopressor), carvedilol (coreg) - carvedilol was on our med sheet so probably on the exam
blocks the effect of sympathetic NS
A nurse is caring for a patient taking diltiazem. The patient reports feeling dizzy when getting out of bed. What is the nurse’s priority action?
A. Notify the provider
B. Encourage fluid intake
C. Assist the patient to rise slowly
D. Hold the next dose
✅ Answer: C. Assist the patient to rise slowly
💡 Rationale:
Calcium channel blockers can cause orthostatic hypotension—because they chill those blood vessels so much, gravity gets rude. Help the patient move slow like they’re sneaking past a sleeping toddler. 😴🚶♀️
A patient with heart failure is prescribed furosemide (Lasix). During the morning assessment, the nurse notes that the patient did not receive their prescribed diuretic yesterday. Which of the following assessment findings would be most concerning?
A. Blood pressure 106/64 mmHg
B. Serum potassium level of 4.8 mEq/L
C. Weight gain of 3 lbs in 24 hours
D. Increased urinary output overnight
Correct Answer: C. Weight gain of 3 lbs in 24 hours
Rationale:
🚨 Your patient is retaining more water than a camel prepping for a desert trip. A 3-lb weight gain overnight is a flashing neon sign for fluid overload — the very thing Lasix is supposed to prevent! Forgetting that dose may have let fluid party all night. Time to bust that bloat!
A nurse is assessing a patient who is taking losartan. Which of the following findings would be most concerning and should be reported to the provider?
A. Dry mouth
B. Constipation
C. Serum potassium level of 5.8 mEq/L
D. Occasional headache
✅ Answer: C. Serum potassium level of 5.8 mEq/L
💡 Rationale:
ARBs like losartan can cause hyperkalemia, which makes your heart feel like it's dancing to the wrong beat. A potassium of 5.8 is too spicy for safety—normal range is 3.5–5.0.
A nurse is preparing to administer amlodipine to a client with hypertension. Which assessment is the nurse's priority before administration?
A. Respiratory rate
B. Apical pulse
C. Blood pressure
D. Oxygen saturation
✅ Answer: C. Blood pressure
💡 Rationale:
Calcium channel blockers like amlodipine are the chill pills of the vascular world—they dilate vessels and lower blood pressure. If the BP is already low, giving it is like putting a sloth on a treadmill—dangerously slow. Always check BP first!
A nurse is caring for a patient prescribed prazosin for hypertension. Which of the following instructions should the nurse include in the patient teaching?
A. "Take your first dose in the morning with breakfast."
B. "Avoid drinking grapefruit juice while on this medication."
C. "You may experience a sudden drop in blood pressure after the first dose."
D. "This medication can cause low potassium, so increase bananas in your diet."
Answer: C. "You may experience a sudden drop in blood pressure after the first dose."
💡 Rationale:
Alpha blockers like prazosin are notorious for the “first-dose phenomenon”—they drop BP like a plot twist in a telenovela. Educate patients to take the first dose at bedtime to reduce the risk of falling flat on their face from sudden hypotension. 🛏️➡️🩺 Not the time to be walking the dog!
Which of the following medications requires the nurse to monitor for angioedema?
A. Furosemide
B. Losartan
C. Metoprolol
D. Digoxin
✅ Answer: B. Losartan
💡 Rationale:
Though less common than with ACEIs, ARBs like losartan can still cause angioedema—aka your face does a pufferfish impression and that’s a respiratory emergency. Teach patients to report swelling of lips, tongue, or throat ASAP. 🐡🫢
The nurse is caring for a patient taking hydrochlorothiazide. Which laboratory result would require immediate action?
A. Sodium 138 mEq/L
B. Chloride 100 mEq/L
C. Potassium 2.9 mEq/L
D. Glucose 108 mg/dL
Correct Answer: C. Potassium 2.9 mEq/L
Rationale:
⚡️ Potassium at 2.9? That’s low enough to make your heart go offbeat like a toddler with a drum set. Thiazide diuretics love to sneak potassium out the back door. We don’t want our patient breakdancing into arrhythmias. Let’s replace that K, STAT!
Which of the following is a priority nursing action before administering an ACE inhibitor to a patient?
A. Check respiratory rate
B. Assess heart sounds
C. Monitor potassium level
D. Measure blood glucose level
✅ Answer: C. Monitor potassium level
💡 Rationale:
ACEIs can sneak potassium past the kidneys like a kid sneaking snacks past bedtime. Too much potassium = arrhythmia risk. So keep an eye on those labs before giving that pill!
A client taking verapamil reports dizziness and lightheadedness when standing up. What is the nurse's best response?
A. "This is a normal side effect. Just take it at bedtime."
B. "You should increase your salt intake to raise your blood pressure."
C. "Get up slowly from sitting or lying positions."
D. "You should stop taking the medication immediately."
✅ Answer: C. "Get up slowly from sitting or lying positions."
💡 Rationale:
CCBs lower blood pressure, and that can make your brain feel like it's in a slow Wi-Fi zone when you stand up too fast. That's called orthostatic hypotension. Teach the client to rise slowly, not quit cold turkey!
A nurse is preparing to administer metoprolol to a patient with hypertension. Which of the following is the most important assessment prior to administration?
A. Temperature
B. Respiratory rate
C. Apical pulse
D. Oxygen saturation
Answer: C. Apical pulse
💡 Rationale:
Beta blockers like metoprolol slow the heart down like it’s on chill mode. 💆♂️ If the apical pulse is too low (usually <60 bpm), hold the dose and notify the provider—because slowing down a slow heart is a one-way trip to Bradycardia-ville. And we are NOT issuing passports for that today.
A nurse is teaching a patient with stable angina how to use sublingual nitroglycerin. Which statement indicates correct understanding?
A. "I can take up to three tablets, 5 minutes apart."
B. "I should swallow the tablet with water."
C. "I’ll take it only after the chest pain is gone."
D. "It’s okay to take it with my erectile dysfunction medication."
✅ Answer: A. "I can take up to three tablets, 5 minutes apart."
💡 Rationale:
Nitro goes under the tongue, not down the hatch! And yes, it can be taken every 5 minutes for up to 3 doses, but call 911 if pain isn’t gone after the first. Never mix with ED meds unless you're into passing out in public. 🚫🍆💊