Ch. 44 - Antihypertensives Flashcards Preview

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Flashcards in Ch. 44 - Antihypertensives Deck (22)
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1
Q

Sympatholytics (Sympathetic Depressants):

A

Beta-Adrenergic Blockers:

 1. ) Beta1 = preferred for HTN
 2. ) Use with a diuretic
 3. ) African American clients DO NOT respond well to beta-blockers

 4.) Depress/supresss Sympathetic Nervous System
2
Q

Example (CardioSELECTIVE beta 1):

A

Metoprolol:

 1. ) Blocks beta 1 receptors 
 2. ) Diminish sympathetic n.s. response = vascular resistance is diminished = decrease BP
3
Q

Metoprolol:

A
  • PO (HTN)
  • IV (MI)

SE:

  1. ) Fatigue, weakness, dizziness
  2. ) Drowsiness, HA, blurred vision
  3. ) Should not be D/C abruptly = rebound       HTN
4
Q

Examples: (Nonselective):

A

propranolol (Inderal):

- Reduce heart rate & force of contraction
- Bronchoconstriction 

DO NOT USE FOR RESPIRATORY PT

5
Q

Nonselective — Side Effects:

A
  1. ) Decreased pulse rate
  2. ) Markedly decreased BP
  3. ) Nonselective:
    - Bronchospasm
    - Inhibits ability to convert glycogen to glucose (problem for diabetic pt)
6
Q

Direct Acting Vasodilators (1):

A

Potent antihypertensive agents

ACTION:
-Directly dilates peripheral arterioles =  decrease BP

7
Q

Direct Acting Vasodilators (2): —- Give with….

A

Heart compensates:
-Palpitations, tachycardia

beta-adrenergic blocking agent to counteract effects of REFLEX TACHYCARDIA

8
Q

Direct Acting Vasodilators (3): —- Decreased BP…..

A

= sodium & water retention = peripheral edema

Diuretics

9
Q

Direct Acting Vasodilators -Side Effects (many):

A
  1. ) Tachycardia, palpitations
  2. ) Edema, nasal congestion
  3. ) HA, dizziness
10
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors (1):

A

Interferes with conversion of angiotensin I to angiotensin II = Peripheral vasodilation

11
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors (2): — Blocks….

A

release of aldosterone =

 - Sodium excreted
 - K+ retained
12
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors — EX:

A

lisinopril (Prinivil, Zestril)

13
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors — Side Effects:

A
  1. ) Irritating, dry cough
  2. ) n/v, diarrhea
  3. ) HA, dizziness, fatigue
  4. ) Hyperkalemia, tachycardia
14
Q

Angiotensin-Converting Enzyme (ACE) Inhibitors — Contraindications:

A
  • Pregnancy = (decrease placental blood flow)

- Not to be taken with K+ sparing diuretics =  hyperkalemia

15
Q

(ACE) Inhibitors — Nursing interventions:

A

Monitor:

  • Renal function
  • Hypoglycemic reaction with DM clients
16
Q

(ACE) Inhibitors — Teach (1):

A

Do not:

  • d/c abruptly
  • Take if pregnant or contemplating pregnancy

How to take own BP & record

17
Q

(ACE) Inhibitors — Teach (2):

A

Dizzy/lightheaded 1st week of therapy

Take captopril (Capoten) 20 min – 1 hr before a meal

18
Q

Calcium Channel Blockers:

A

Calcium:
-Increase myocardial heart contraction, peripheral restistance & blood pressure

Calcium blockers:
-Promote vasodilation = decrease BP

19
Q

Calcium Channel Blockers – Examples:

A

verapamil (Calan)

nifedipine (Procardia)

20
Q

Calcium Channel Blockers – Side Effects:

A
  • HA
  • Hypotension
  • Dizziness, flushing
21
Q

Nursing Process – Long Term Management (HTN) (1):

A
  1. ) Wt loss, exercise (aerobic)
  2. ) Stop smoking
  3. ) Avoid alcohol
  4. ) Coping with stress
  5. ) OTC = labels can be contraindcated
22
Q

Nursing Process – Long Term Management (HTN) (2) —- Teach:

A

Do not stop taking meds just because BP is down

Active in self care