Hypertension
How do ACE inhibitors work?
inhibit the conversion of of angiotensin 1 to angiotensin 11 by preventing vasoconstriction also inhibiting aldosterone secretion which then also prevents Na + and water resorption
What do ARBs end in?
Sartan
What do calcium channel blockers most commonly end with and what are the 2 that dont end with the common ending?
Pine, Diltazem, verapamil
what are the alpha and non-selective beta blockers?
Carvedilol, labetalol
The nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?
A. Blood volume and renal blood flow
B. Cardiac output and systemic vascular resistance
C. Heart rate and peripheral resistance
D. Myocardial contractility and arteriolar constriction
B. Cardiac output and systemic vascular resistance
What do ACE inhibitors end with?
Prils
What are the nursing considerations for ARBS?
Potassium levels must be regularly monitored
Monitor kidney function labs
monitor serum sodium levels
how do beta blockers work?
Where do beta 1 receptors act?
Where do beta 2 receptors act?
block SNS stimulation of the beta-adrenergic receptors by competing with norepinephrine and epinephrine
Heart
Lungs
A client with severe liver disease is receiving the angiotensin-converting enzyme (ACE) inhibitor, catopril. The nurse is aware that the advantage of this drug for this clients is which characteristic?
A. Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug
B. Captopril rarely causes first-dose hypotensive
C. Captopril has little effect on electrolyte levels
D. Captopril is a prodrug and is metabolized by the liver before becoming active.
A. Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug
When counseling a male client about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?
A. Impotence
B. Weight gain
C. increased libido
d. Headache
A. Impotence
What are the nursing considerations for ACE inhibitors?
potassium levels must be regularly monitored
monitor kidney function labs
Assess for dry, hacking cough
Monitor serum sodium levels
How do calcium channel blockers work?
block calcium from binding to its receptors to prevent contraction also relaxes smooth muscles
increases blood flow to coronary arteries
reduces SVR
What are the adverse effects of beta blockers?
Bradycardia, depression, impotence, constipation, fatigue, may mask or blunt symptoms of hypoglycemia such as tachycardia tremor or nervousness, bronchoconstriction, sudden withdrawl from the drug may lead to angina MI rebound HTN,
The nurse is reviewing the orders for a client and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?
A. NSAIDS
B. antibiotics
C. opioids
D. Antacids
NSAIDs
A client with primary hypertension is prescribed drug therapy for the first time. The client asks how long drug therapy will be needed. Which answer by the nurse is the correct response?
A. this therapy will go on until your symptoms disappear
B. this therapy will take about 3 months
C. this therapy will take about a year
D. therapy for high blood pressure is usually lifelong
D. Therapy for high blood pressure is usually lifelong
how do ARBS work?
block vasoconstriction by decreasing systemic vascular resistance they also block the secretion of aldosterone by preventing Na+ and water resorption
What are the adverse effects of calcium channel blockers?
hypotension, palpitations, tachycardia or bradycardia, constipation, nausea, dyspnea, rash, flushing, peripheral edema
What are the selective beta blocks that only affect the heart
atenolol, metoprolol tartrate, metoprolol succinate, nebivolol
a client with hypertension will be receiving a new prescription for lisinopril. The nurse is reviewing the clients laboratory results and will report which of these as a potential contraindications?
A. Serum sodium level 136 mEq/L
B. Elevated white blood cell count
C. Serum potassium 5.8 mEq/L
D. Elevated AST level
Serum Potassium 5.8 mEq/L
If a client develops a severe cough from an ACE inhibitor what medication do you suspect the DR. to prescribe next?
An ARB
What are the side effects of ARBs?
chest pain, fatigue, hypoglycemia, diarrhea, UTI, anemia, weakness, hypotension
What are the nursing considerations for calcium channel blockers?
educate patients to avoid grapefruit juice
Daily weights are needed- educate patient to do this at home as well
Monitor for edema and SOB
increase fluids and fiber- unless contraindicated
educate patients to avoid: alcohol, saunas, hot tubs, hot showers, and/or hot enviroments- because hot enviroments increase vasodilation increases the risk of orthostatic hypotension in turn increasing the injury risk
Monitor HP and HR
What are the non-selective beta blockers?
propranolol
What are the nursing considerations for beta blockers?
educate patient to avoid: alcohol, saunas, hot tubs, hot showers, and/or hot enviroments
Assess breath sounds
Monitor blood glucose levels in diabetic patients
Assess apical pulse for 1 minute prior to adminstering
assess for s/s of bradycardia after administration
Daily weights are needed- educate patient to do this at home 2 pound weight gain 24 hrs. or 5-pound fain in a week
antihypertensive medication nursing considerations?
check BP and HR prior to administering
Educate patients not to stop taking abruptly, rebound HTN may occur
Teach patients to monitor their BP and HR at home prior to taking antihypertensive medications--keep a log of these readings
educate patients to take these medications exactly as prescribed
educate patients to change positions slowly, to prevent injury r/t orthostatic hypotension
most antihypertensive drugs are better tolerated when taken with food
teach patients to report adverse effects changes may need to be made
assess for compliance with medication regimen