Perfusion Part One

Question 1

Very Nice Drugs

Answer 1

Verapamil,Nifedipine, Diltiazem

Question 2

-pril

Answer 2

ACE inhibitors

Question 3

-sartan

Answer 3

Angiotensin II. Receptor Blockers

Question 4

-OLOL

Answer 4

Beta Blockers

Question 5

RAAS

Answer 5

Renin Angiotensin Aldosterone System
1. Receptors recognize pressure change in vessels which stimulates kidneys to release renin into the bloodstream ( whenever BP is low)
2. Liver makes angiotensinogen which reacts with renin
3. This forms angiotensin I
4.Angiotensin 1 to Angiotensin II occurs in the lungs
5. Angiotensin II makes blood vessels small in diameter increasing BP (vasoconstrictor)
6. Angiotensin II to Angiotensin III releasing aldosterone
7. Aldosterone - BV increases and BP increases
Once optimal BP is reaches the kidneys will stop producing renin

Question 6

Primary HTN

Answer 6

cause is unknown 90%

Question 7

Secondary HTN

Answer 7

Cause/reason is known
10%

Question 8

ANtihypertensive Drug Classifications

Answer 8

Ace inhibitors, ARBs, Beta Blockers, Ca Channel Blockers, Diuretics, Vasodilators

Question 9

Antihypertensive Assess

Answer 9

Risk Factors (non modifiable and modifiable)
Check for High BP on multiple measurements

Question 10

How many readings do you need to verify hypertension?

Answer 10

2

Question 11

Antihypertensives Implement/Teach

Answer 11

Lifestyle change, take as prescribed, do not stop abruptly, proper BP taking technique, reduce coffee, ETOH, OTC meds

Question 12

Antihypertensive Evaluate

Answer 12

BP WNL

Question 13

Ace Inhibitors Use

Answer 13

HTN, heart failure

Question 14

Ace Inhibitor Action

Answer 14

Prevents the conversion angiotensin I to II which prevents the release of aldosterone

Question 15

Ace Inhibitor Adverse Effects

Answer 15

dry, nonproductive cough, which reverses when therapy is stopped, impotence, angioedema, Possible hyperkalemia~ ­K (> 5 meq/L) ­Mg, cardiac rhythm changes, cramping, diarrhea

Question 16

What foods should you avoid when taking ace inhibitors?

Answer 16

Avoid high potassium items like bananas, zucchini, dried fruit, potatoes, spinach and salt substitutes

Question 17

Arbs

Answer 17

Well tolerated, newer class
Do not cause a dry cough

Question 18

Arbs Action

Answer 18

Allow angiotensin I to be converted to angiotensin II, but block the receptors that receive angiotensin II
Blocks vasoconstriction and release of aldosterone which lowers BP

Question 19

ARBs drug examples

Answer 19

Losartan valsartan

Question 20

Beta Blocker Use

Answer 20

HTN

Question 21

Beta Blocker Action

Answer 21

Prevent/block beta receptors to accept epinephrine/nor- epinephrine

Question 22

Beta Blocker Assess

Answer 22

• HTN,
•S/s of asthma, decreased HR, check for postural hypotension

Question 23

Beta Blocker Implement/Teach

Answer 23

Check pulse, hold rate < 60, don’t stop abruptly

Question 24

Beta Blocker EValuate

Answer 24

BP HR

Question 25

Calcium Channel Blockers Use

Answer 25

HTN,angina,tachyarrhythmias

Question 26

Calcium Channel Blockers Drugs

Answer 26

Verapamil, Nifedipine, Dilitazem

Question 27

Calcium Channel Blockers Action

Answer 27

dilates peripheral arteries by relaxing vascular smooth muscle

Question 28

Ca Channel Blockers Teach

Answer 28

Do not drink grapefruit juice because it will increase the concentration of the calcium channel blockers

Question 29

Contraindications of Ca channel blockers

Answer 29

Hypersensitivity

Question 30

Alpha Adrenergic Receptor Blockers (Alpha Arbs) Use

Answer 30

Mild to moderate HTN, increases urinary flow rates

Question 31

Alpha Adrenergic Receptor Blockers (Alpha Arbs) Action

Answer 31

blocks alpha1 receptors in arterial smooth-muscle vasculature & decreases BP which is also found in the neck of the bladder

Question 32

Alpha Adrenergic Receptor Blockers (Alpha Arbs) Major Adverse Effects

Answer 32

• orthostatic hypotension, tachycardia, fluid retention, dizziness

Question 33

Alpha Adrenergic Receptor Blockers Assess/monitor

Answer 33

• BP & HR •I&O • Elimination pattern (Offer stool softener or antidiarrheal)

Question 34

Alpha arbs Implement

Answer 34

• BP & HR •I&O • Elimination pattern (Offer stool softener or antidiarrheal)

Question 35

Alpha Arbs Instruct

Answer 35

• To eat low sodium diet • Rise slowly • Be compliant with therapy • Avoid OTC unless checking with MD

Question 36

Vasodilator Action

Answer 36

• Relaxes arteriolar smooth muscle causing vasodilatations, which decreases BP

Question 37

Vasodilators Use

Answer 37

Moderate to severe HTN & hypertensive crisis (requires immediate reduction )

Question 38

Hydralazine IV

Answer 38

Vasodilator • Have a continuous BP monitor if available • VS q 5 to 15 minutes with IV use • Titrate IV dose to BP • Do not leave pt unmonitored

Question 39

Hydralazine Side effects

Answer 39

Headache,dizziness, feelings of anxiety, edema, nausea, vomiting, tachycardia

Question 40

Arrhythmia

Answer 40

Change to the automaticity or conductivity of heart cells

Question 41

Class I Anti-arrhythmic Agents

Answer 41

Sodium Channel Blockers

Question 42

Class II Anti-arrhythmic Agents

Answer 42

Beta Blockers

Question 43

Class III Anti-arrhythmic Agents

Answer 43

Potassium Channel Blockers

Question 44

Adenosine

Answer 44

Used to treat Supra-ventricular tachycardia Given IV push Given very rapidly

Question 45

Class IV Anti-arrhythmic Agents

Answer 45

Calcium Channel Blockers

Question 46

Digoxin

Answer 46

Heart failure medication that can also be used to treat low heart rate

Question 47

Sodium Channel Blockers

Answer 47

Local anesthetic numbing agent for skin Procainamide, quinidine,lidocaine Blocks sodium channels from opening which causes decrease in HR

Question 48

Sodium Channel Blockers Use

Answer 48

Ventricular arrhythmias

Question 49

Sodium Channel Blockers Contraindications

Answer 49

Hypersensitivity, Brady, heart block, hypotension, HF

Question 50

Sodium Channel Blockers Contraindications

Answer 50

Hypersensitivity, Brady, heart block, hypotension, HF

Question 51

Sodium Channel Blockers Side Effects

Answer 51

dizziness, drowsiness, fatigue, vision changed, development of arrhythmias, hypotension, vasodilation

Question 52

Potassium Channel Blockers

Answer 52

Amiodarone, dofetilide, sotalol

Question 53

Potassium Channel Blockers Use

Answer 53

Ventricular fibrillation; pulseless Vtach

Question 54

Potassium Channel Blockers Contraindication

Answer 54

None if it is a life threatening situation

Question 55

Potassium Channel Blockers Side Effects

Answer 55

Weakness fatigue dizziness hypotension HF arrhythmias

Question 56

Amiodarone Side Effects

Answer 56

Fatal liver toxicity, pulmonary toxicity, vision changes, cardiac arrhythmias

Question 57

Nursing Interventions for anti arrhythmic agents

Answer 57

-monitor cardiac rhythm -stabilize pt Ventilation, o2, treat hypotension Safety precautions