Exam 4 - HTN - Chapter 26

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  1. What do diuretics do for HTN?
    lower blood volume through urinary excretion of water and electrolytes
  2. what electrolytes are affected by diuretics to treat HTN?
    • Na+
    • Ca+
    • Cl-
    • K+
  3. what labs are monitored in diuretic treatment
    • BMP
    • BUN
    • LFT's
    • Cholesterol panel
    • Glucose
  4. what is the normal adult BP range?
    <120 / <80
  5. what is consider prehypertensive?
    120-139 / OR 80-89
  6. what is considered Stage 1 hypertension?
    140-159 / OR 90-99
  7. what is considered Stage 2 hypertension?
    ≥160 / OR ≥100
  8. non-pharmacological interventions to reduce or prevent HTN?
    • limit ETOH
    • restrict salt <1500mg/day
    • reduce intake of sat fat and cholesterol
    • increase fruits / vegetables
    • increase aerobic activity
    • d/c tobacco
    • manage stress
    • maintain optimal weight
    • consume K+, Ca+, Mg+
  9. Name the classifications of primary anti-HTN agents
    • diuretics
    • Ca+ Channel Blockers
    • ACE Inhibitors
    • ARB (Angiotensin II Receptor Blockers)
    • Beta Blocker
    • Alpha1 adrenergic blocker
    • Alpha2 adrenergic blocker
  10. With any drug that vasodilates (Ca+ channel blockers) what is a major concern?
    congestive heart failure
  11. which anti-HTN class of drug should be used with caution in patients with asthma (due to adverse effect of bronchoconstriction)?
    Beta-adrenergic blockers (Beta-blockers)
  12. what is the action of Microzide (hydrochlorothiazide)?
    • Diuresis via ↓ kidney absorption
    • ↓BP and workload
  13. what are the side effects of Microzide (hydrochlorothiazide)?
    • electrolyte imbalances (Na+, K+)
    • gout
    • ↑lipids
    • ↑BS
    • blood dyscrasias
    • ED
  14. what are the nursing considerations of Microzide (hydrochlorothiazide)?
    • I/O's
    • fatigue
    • vitals (BP/HR/weights)
    • fall risk (dizziness)
    • diuresis
    • hypo/hyperkalemia s/s
  15. what are the labs to monitor for Microzide (hydrochlorothiazide)?
    • BMP
    • BUN
    • LFT's
    • Cholesterol
    • Glucose
    • CBC
  16. what is the action of Lasix (furosemide)?
    • Most diuresis via ↓kidney LOOP absorption
    • ↓BP and workload
  17. what are the side effects of Lasix (furosemide)?
    • electrolyte imbalances
    • orthostatic hypotension (syncope)
    • OTOTOXICITY**
    • BLACK BOX: may lead to profound diuresis with water and electrolyte depletion
  18. what is the normal K+ range?
    3.5 - 5.0 mEq/L
  19. what are the nursing considerations of Lasix (furosemide)?
    • I/O's
    • fatigue
    • vitals (BP/HR/weights)
    • fall risk (dizziness)
    • diuresis
    • hypokalemia s/s
  20. what are the labs to monitor with Lasix (furosemide)?
    • BMP
    • BUN
    • LFT's
    • Cholesterol
    • Glucose
    • CBC
  21. what is the action of Aldactone (spironolactone)?
    • acts on distal convoluted tubule
    • blocks action of aldosterone
    • ↑ Na+ excretion
    • ↓ K+ excretion
  22. what are the side effects of Aldactone (spironolactone)?
    • hyperkalemia
    • arrhythmias
    • HA
    • fatigue
    • dizziness
    • blood dyscrasias
    • Men-gynecomastia, impotence, ↓ libido
    • Women-hirsutism, breast tenderness, menstrual irregularities, voice deepening
  23. what are the nursing considerations of Aldactone (spironolactone)?
    • monitor I/O's
    • fatigue
    • monitor vitals (BP/HR/weights)
    • risk for falls (dizziness)
    • diuresis
    • monitor labs
    • s/s of hyperkalemia
  24. what are the labs to monitor for Aldactone (spironolactone)?
    • BMP
    • BUN
    • LFT's
    • CBC
  25. what is the action of Procardia (nifedipine)?
    • causes vasodilation, decreasing BP
    • works on ARTERIOLES
  26. what class of drug is Procardia (nifedipine)?
    Ca+ channel blocker
  27. what class of drug is Microzide (hydrochlorothiazide)?
    thiazide diuretic
  28. what class of drug is Lasix (furosemide)?
    loop diuretic
  29. what class of drug is Aldactone (spironolactone)?
    K+ sparing diuretic
  30. what are the side effects of Procardia (nifedipine)?
    ↓peristalsis of bowels=constipation

    • dizziness
    • HA
    • arrhythmias
    • peripheral edema
    • brady or tachy
    • flushing
    • Nausea (GI upset)
    • possible male infertility
    • sexual difficulties
  31. what are the nursing considerations of Procardia (nifedipine)?
    • monitor BP/HR (REPORT <90/60
    • falls risk due to dizziness
    • monitor labs
    • daily weights
    • safe and well tolerated by elderly and afro-american
  32. what are the labs to monitor for Procardia (nifedipine)?
    • renal function
    • LFT's
  33. what is the action of Vasotec (enalapril)?
    • reduces levels of angiotensin II (vasoconstrictor) and aldosterone
    • ↓BP and workload lowering peripheral resistance & blood volume
  34. what class of drug is Vasotec (enalapril)?
    ACE inhibitor (prils)
  35. what are the adverse effects of Vasotec (enalapril)?
    • cough
    • postural hypotension
    • hyperkalemia
    • angioedema (↑ risk with AfroAmerican)
    • renal failure
    • agranulocytosis
  36. what are the nursing considerations of Vasotec (enalapril)?
    • monitor BP/HR
    • falls risk (dizziness)
    • monitor labs
    • daily weights
  37. what are the labs to monitor for Vasotec (enalapril)?
    • BUN
    • creatinine
    • LFT's
    • ALP
    • CBC
  38. what is the action of Coreg (carvedilol)?
    • block cardiac contractility
    • slows HR and BP
    • reduces workload of the heart
  39. what class of drug is Coreg (carvedilol)?
    beta-blocker
  40. what are the adverse effects of Coreg (carvedilol)?
    • fluid retention
    • worsening of heart failure
    • fatigue
    • hypotension
    • bradycardia
    • heart block
    • ↓ libido
    • impotence
    • depression
    • lethargy
    • DMI ↓BS / DMII ↑BS
  41. what are the nursing considerations of Coreg (carvedilol)?
    • Hold if HR <60
    • monitor BP/HR
    • falls risk (dizziness)
    • monitor labs
    • daily weights
  42. what are the labs to monitor Coreg (carvedilol)?
    • BUN
    • cholesterol panel
    • BMP (K+)
    • uric acid
  43. what does the acronym "A Boy Has Kicking Legs" stand for?
    • Alpha 1 - ARTERIOLE smooth muscle (vasoconstrict to ↑BP)
    • Alpha 2 - BRAIN inhibits (regulates) CNS output of epinephrine
    • Beta 1 - HEART rate and strength of contraction; KIDNEYS release renin
    • Beta 2 - LUNGS (bronchioles) bronchodilate and skeletal muscle
  44. Alpha 1 - affects what receptors?
    • ARTERIOLE
    • vasoconstricts to ↑BP
  45. Alpha 2 - affects what receptors?
    • BRAIN
    • regulates CNS output of EPI
  46. Beta 1 - affects what receptors?
    • HEART - rate and strength of contraction
    • KIDNEYS - release of renin
  47. Beta 2 affects what receptors?
    LUNGS - bronchodilation of bronchioles and skeletal muscle
  48. What drugs affect the RAAS system?
    (Renin-angiotensin-aldosterone-system)
    • Diuretics
    • ACE inhibitors
    • ARB's
  49. What class of drugs inhibit the sympathetic nervous system?
    • Beta blockers
    • Alpha blockers (alpha adrenergic agonists)
    • Ca+ channel blockers
  50. what role does aldosterone play in our system?
    retains sodium and water follows

    Angiotensin II triggers release of aldosterone
  51. Angiotensin II is known as one of the most potent...?
    VASOCONSTRICTORS

    ↑BP
  52. ACE inhibitors are what nickname?
    • "prils"
    • lisinopril
    • enalapril
  53. ARB's (Angiotensin II Receptor Blockers) are what nickname?
    • "sartans"
    • valsartan
    • losartan
  54. Beta Blockers are what nickname?
    • "olols"
    • metoprolol
    • propranolol
  55. Alpha adrenergic blockers are what nickname?
    • "zosins"
    • doxazosin
    • prazosin (Minipress)
  56. Ca+ channel blockers are what nickname?
    • "dipines"
    • nifedipine
    • amlodipine

    ALSO diltiazem and verapamil
  57. Vasodilation does what?
    • relaxes smooth muscles of blood vessels
    • drops BP
    • increases water and Na+ retention
  58. what is the drug of choice in a hypertensive emergency?
    Nipride (sodium nitroprusside)

Card Set Information

Author:
cbennett
ID:
329666
Filename:
Exam 4 - HTN - Chapter 26
Updated:
2017-03-28 01:59:52
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pharmacology
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Description:
Exam 4 - HTN - Chapter 26
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