Anti HTN Flashcards
Hypertensive crisis
Systolic over 180 and/or
Diastolic over 120
Pt without s/s=med adjustment
Pt with s/s=immediate ED visit
HA
Vision issues (double, loss, ⬇️, color change)
N/V
Teaching points with anti HTN med usage
White coat syndrome
Orthostatic hypotensive issues can occur
1-3 months for body to adjust and chemically lower BP
HTN is usually found randomly
Most common long term issues: AMI and CVA
Before giving anti HTN
Take BP everytime you are scheduled to give
Hold and call presciber if SBP <90 mmHg
Consider immediate help if SBP < 70 mmHg
HTN risk factors
Modifiable:
Smoking
DM
Obesity
⬆️ cholesterol/lipids (clogs arteries)
Non-modifiable:
>60 years of age
Gender (males and postmenopausal females
Race (African-American)
Primary vs secondary HTN
Primary:
idiopathic: cause unknown
Accounts for 90% of all HTN cases
Secondary:
-10% of all cases
Something is causing it:
Pheochromocytoma
toxemia
renal disease
Anti-hypertensive ACE-inhibitors MOA
Renin-Angiotensin-aldosterone system:
*renin—angiotensinogen—angiotensin I—ACE—angiotensin II—adrenal—produces aldosterone—increased BP
ACE inhibitor action
ACE inhibitors
-prils
Block angiotensin I from becoming ACE
ACE inhibitors
Clinical indications
Hypertension
Heart failure
Myocardial infarction
Insulin resistance
(protects kidneys so good for diabetes)
Antihypertensive ace inhibitors
SE/AR
Renal insufficiency
Hyperkalemia
Hypotension
Dry cough***
Rash
Angioedema (facial swelling)
Antihypertensives ACE inhibitors
Nursing considerations
Pt education
VS
History of OTC meds
Pt precautions
No need for continuation of K+ supplements
Angioedema (watch for swelling in face)
If ace doesnt help use what
Angiotensin II receptor blockers (ARBs)
Angiotensin II receptor blockers (ARBs)
“ARBs”
ACE inhibitors block production of angiotensin II
Blocks actions of aniotensin II (a potent vasoconstrictor)
Similar to ACE inhibitors but do not cause:
hyperkalemia
Dry hacking cough
Angioedema
Too expensive
Angiotensin II receptor blockers (ARBs)
What do they end with
-sartan
Anti-hypertensives aldosterone antagonists
What they do
Meds names
SE
Blocking the release of aldosterone promotes excretion of Na/water and retention of potassium
Meds:
-one
SE:
Hyperkalemia
Antihypertensives diuretics
3 types
Loop diuretics
Thiazide diuretics
Potassium-sparring diuretics
