Medications used for Management of Hypertension

Question 1

*Decreases blood volume, renal blood flow, and CO
*directly affects smooth muscle
*Can cause natriuresis

Answer 1

Effect of diuretics

Question 2

negative sodium balance

Answer 2

natriuresis

Question 3

Nursing implication for a person taking diuretics (Name 3)

Answer 3

Monitor K+ levels
I/O monitoring
BP monitoring
Give in AM to prevent nocturia
Falls Risks
Orthostatic Hypotension

Question 4

What is the action of Angiotensin-Converting Enzyme (ACE) Inhibitors

Answer 4

Stops ACE from converting ANG I into ANG II, causing a reduction of peripheral resistance (decrease PVR)

Question 5

Side effects of Angiotensin-Converting Enzyme (ACE) Inhibitors

Answer 5

Hyperkalemia, Tachycardia, hypotension, azotemia, angioedema (rare- more common in African Americans), Potassium retention, dry cough (ANG I is produced in the lungs- when inhibited, it causes dry cough)

Question 6

Captopril, lisinopril, & benazepril

Answer 6

Common ACE-Inhibitors (ending -pril)

Question 7

Contraindications of ACE inhibitor and ARBs

Answer 7

Pregnancy

Question 8

Nursing implications for a person taking ACE Inhibitors

Answer 8

*Monitor BP
*BUN & Creatinine
*Not as expensive as ARBs

Question 9

What is the action of Angiotensin II Receptor Blockers (ARBs)

Answer 9

Blocks the effects of ANG II at the receptor causing inhibition of vasoconstriction and release of aldosterone; reduces peripheral resistance and water retention

Question 10

Side effects of Angiotensin II Receptor Blockers (ARBs)

Answer 10

hyperkalemia, positional hypotension/orthostatic

Question 11

Irbesartan, valsartan, & losartan

Answer 11

Common ARBs (ending -sartan)

Question 12

Nursing implications for a person taking ARBs

Answer 12

*Monitor K+
*Monitor BP
*Do NOT take with an ACE inhibitor
*Expensive

Question 13

Common site of beta-receptors

Answer 13

heart (b-1) and lungs (b-2)

Question 14

What is the action of beta-adrenergic receptors

Answer 14

Beta-adrenergic receptors of the SNS cause vasodilation and decrease CO and HR to allow the heart to beat slower but stronger

Question 15

Inotropes

Answer 15

Increase cardiac contractility, which improves cardiac output (CO), aiding in maintaining MAP and perfusion to the body.

Question 16

Metoprolol, Atenolol, Carvedilol, & Labetalol

Answer 16

Common beta-blockers (ending -lol)

Question 17

Side effects of beta blockers

Answer 17

Rebound tachycardia, vomiting and diarrhea, urinary frequency, and tachycardia if not controlled w/ beta blockers, drowsiness

Question 18

Contraindications of Beta-blockers

Answer 18

asthma and COPD

Question 19

Nursing implications of a person taking Beta-blockers

Answer 19

DO NOT STOP ABRUPTLY
*Monitor BP
Orthostatic hypotension
CHF

Question 20

What is the action of Calcium Channel Blockers

Answer 20

Inhibits Ca++ ion reflux; reduces cardiac afterload, workload (slows HR)

Question 21

Side effects of Calcium Channel Blockers

Answer 21

Stephen-Johnson Syndrome, orthostatic hypotension, bradycardia, CHF dizziness, edema

Question 22

contraindications of calcium channel blockers

Answer 22

sick sinus syndrome, heart blocks (AV electrical signal block causing partial or blocked heart contraction

Question 23

Nursing implications of a person taking calcium channel blockers

Answer 23

*Monitor BP
*Continue regimen- do NOT discontinue suddenly
*Monitor HR
*Monitor GI symptoms

Question 24

Amlodipine, Nifedipine, Diltiazem, Cardizem, Verapamil

Answer 24

Common Calcium Channel Blockers (common ending -dipine, plus others like -zem, -amil)