Ch. 44 - Antihypertensives

Question 1

Sympatholytics (Sympathetic Depressants):

Answer 1

Beta-Adrenergic Blockers:

 1. ) Beta1 = preferred for HTN
 2. ) Use with a diuretic
 3. ) African American clients DO NOT respond well to beta-blockers

 4.) Depress/supresss Sympathetic Nervous System

Question 2

Example (CardioSELECTIVE beta 1):

Answer 2

Metoprolol:

 1. ) Blocks beta 1 receptors 
 2. ) Diminish sympathetic n.s. response = vascular resistance is diminished = decrease BP

Question 3

Metoprolol:

Answer 3

• PO (HTN)
• IV (MI)

SE:

  1. ) Fatigue, weakness, dizziness
  2. ) Drowsiness, HA, blurred vision
  3. ) Should not be D/C abruptly = rebound       HTN

Question 4

Examples: (Nonselective):

Answer 4

propranolol (Inderal):

- Reduce heart rate & force of contraction
- Bronchoconstriction 

DO NOT USE FOR RESPIRATORY PT

Question 5

Nonselective — Side Effects:

Answer 5

1. ) Decreased pulse rate
2. ) Markedly decreased BP
3. ) Nonselective:
   - Bronchospasm
   - Inhibits ability to convert glycogen to glucose (problem for diabetic pt)

Question 6

Direct Acting Vasodilators (1):

Answer 6

Potent antihypertensive agents

ACTION:
-Directly dilates peripheral arterioles =  decrease BP

Question 7

Direct Acting Vasodilators (2): —- Give with….

Answer 7

Heart compensates:
-Palpitations, tachycardia

beta-adrenergic blocking agent to counteract effects of REFLEX TACHYCARDIA

Question 8

Direct Acting Vasodilators (3): —- Decreased BP…..

Answer 8

= sodium & water retention = peripheral edema

Diuretics

Question 9

Direct Acting Vasodilators -Side Effects (many):

Answer 9

1. ) Tachycardia, palpitations
2. ) Edema, nasal congestion
3. ) HA, dizziness

Question 10

Angiotensin-Converting Enzyme (ACE) Inhibitors (1):

Answer 10

Interferes with conversion of angiotensin I to angiotensin II = Peripheral vasodilation

Question 11

Angiotensin-Converting Enzyme (ACE) Inhibitors (2): — Blocks….

Answer 11

release of aldosterone =

 - Sodium excreted
 - K+ retained

Question 12

Angiotensin-Converting Enzyme (ACE) Inhibitors — EX:

Answer 12

lisinopril (Prinivil, Zestril)

Question 13

Angiotensin-Converting Enzyme (ACE) Inhibitors — Side Effects:

Answer 13

1. ) Irritating, dry cough
2. ) n/v, diarrhea
3. ) HA, dizziness, fatigue
4. ) Hyperkalemia, tachycardia

Question 14

Angiotensin-Converting Enzyme (ACE) Inhibitors — Contraindications:

Answer 14

• Pregnancy = (decrease placental blood flow)

- Not to be taken with K+ sparing diuretics =  hyperkalemia

Question 15

(ACE) Inhibitors — Nursing interventions:

Answer 15

Monitor:

• Renal function
• Hypoglycemic reaction with DM clients

Question 16

(ACE) Inhibitors — Teach (1):

Answer 16

Do not:

• d/c abruptly
• Take if pregnant or contemplating pregnancy

How to take own BP & record

Question 17

(ACE) Inhibitors — Teach (2):

Answer 17

Dizzy/lightheaded 1st week of therapy

Take captopril (Capoten) 20 min – 1 hr before a meal

Question 18

Calcium Channel Blockers:

Answer 18

Calcium:
-Increase myocardial heart contraction, peripheral restistance & blood pressure

Calcium blockers:
-Promote vasodilation = decrease BP

Question 19

Calcium Channel Blockers – Examples:

Answer 19

verapamil (Calan)

nifedipine (Procardia)

Question 20

Calcium Channel Blockers – Side Effects:

Answer 20

• HA
• Hypotension
• Dizziness, flushing

Question 21

Nursing Process – Long Term Management (HTN) (1):

Answer 21

1. ) Wt loss, exercise (aerobic)
2. ) Stop smoking
3. ) Avoid alcohol
4. ) Coping with stress
5. ) OTC = labels can be contraindcated

Question 22

Nursing Process – Long Term Management (HTN) (2) —- Teach:

Answer 22

Do not stop taking meds just because BP is down

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