PrepU Hypertension Flashcards
(40 cards)
Why should over-the-counter cold medicines be avoided in ct. taking antihypertensive medication?
Could cause serious hypotension (HTN) if doubling doses. May precipitate HTN.
Stopping antihypertensive abruptly can cause what?
A severe hypertensive reaction (not recommended)
What is true about differences in blood pressure taken on opposite arms?
Pressure should not differ more than 5 mm Hg between arms
Difference between hypertensive emergency and hypertensive urgency?
Emergency involves target organ damage.
What types of medications are used to treat hypertension emergency?
IV vasodilators
What class of medication is used to treat hypertensive emergencies?
-oral fast-acting agents such as
- beta-adrenergic blocking agents
- angiotensin-converting enzyme inhibitors
- alpha agonists
Which diuretic agent may cause gout attacks and sudden joint point.
Thiazide
A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for this client after administering the loop diuretic?
Increased blood glucose levels using a blood glucometer test (may be elevated or urine may test positive for glucose)
Modifiable risk factors for hypertension:
-high blood cholesterol levels (HDL specifically)
-cigarette smoking
-obesity and visceral fat
-fitness level
-alcohol consumption
-insulin resistance and metabolic abnormalities
-obstructive sleep apnea.
How many mg/day is considered a low-sodium diet?
500 mg/day
A patient is admitted to the unit with problems controlling their serum glucose levels. The patient has hypertension as a co-morbidity, and the physician has ordered hydralazine for this patient. The nurse caring for this patient knows that hydralazine is a(n):
A. indirect vasodilator
B. direct vasoconstrictor
C. direct vasodilator
D. indirect vasoconstrictor
C; most are reserved for use in severe hypertension or hypertensive emergencies:
-diazoxide
-hydralazine (generic)
-minoxidil
-nitroprusside
A client receiving an ACE inhibitor reports a problem with coughing. The nurse would ask the client if the client is receiving
A. lisinopril
B. benazepril
B: Benazepril is associated with an unrelenting cough.
Alpha1-adrenergic receptor blocker can increase risk for what side-effect, so therefore should be taken at night?
orthostatic hypotension and falls
When are direct vasodilators indicated?
When other drug therapies do not achieve the desired reduction
The nurse is caring for an elderly client with a diagnosis of hypertension, who is taking several antihypertensive medications. Which safety precaution is the nurse most likely to reinforce?
A. Eating extra potassium to make up for lost minerals due to medications
B. walking as far as the ct. can every day
C. Changing positions slowly related to possible hypotension
D. Keeping follow up appointments
C.
Elderly have impaired cardiovascular reflexes and are more sensitive to extracellular volume depletion caused by diuretics and sympathetic inhibition caused by adrenergic antagonists.
-This safety precaution will help prevent falls.
-Eating extra potassium is not a good idea if the ct. is taking a potassium-sparing diuretic.
-Both other points are good for education but are not safety precautions
A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize?
A. Do not smoke for at least 8 hours before a blood pressure reading
B. Sit quietly for 5 minutes prior to taking blood pressure
C. Be sure the forearm is well supported above heart level while taking blood pressure
D. Keep legs crossed while taking BP
B.
Instructions for taking BP at home include:
1- Avoid smoking cigarettes or drinking caffeine for 30 min. before measuring BP
2- Sit quietly for 5 minutes before measurement
3- Have the forearm supported at heart level, with both feet on the ground during the measurement
Which finding indicates that hypertension is progressing to target organ damage?
A. Retinal blood vessel damage
B. Urine output of 60 mL over 2 hours
C. A BUN concentration of 12 mg/dL
D. Assess for presence of pneumonia
A: Eye exam with opthalmoscope = evidence of vascular damage = early detection. If there is damage to the eye, there is likely damage occurring in the body.
Both other answers are normal.
Pneumonia does not indicate target organ damage
When blood pressure is measured, pressure rises during ventricular contraction, then falls during relaxation. As the pressure falls, there is a brief rise as the aortic valve closes. This rise is known by which terminology?
Dicrotic notch
An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident’s medication regimen may create a risk for:
A. constipation
B. falls
C. xerostomia
D. depression
B:
Angiotensin II receptor blockers are associated with a risk of dizziness and a consequent risk for falls, which is more pronounced among older adults.
What is the therapeutic effect of captopril (Capoten), ramipril & quinapril?
Inhibits ACE needed to change inactive angiotensin I to active angiotensin II. = decreases secretion of aldosterone, thus preventing sodium and water retention.
*Decreases peripheral vascular resistance
*lowers blood pressure
Therapeutic action of medications such as verapamil?
calcium channel blockers block movement of calcium ions into arterial smooth muscles. They also dilate coronary and peripheral arteries
Therapeutic value of eplerenone (Inspra)?
Inhibits aldosterone from binding to mineralocorticoid receptors
A client is receiving fosinopril. Which adverse effect would the nurse caution the client about to help promote compliance?
Cough.
Besides cough, what are some other adverse side effects that can be caused by ACE inhibitors?
-GI irritation
-constipation
-photosensitivity
