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htn Flashcards

1
Q

What is the MOA of hydrochlorothiazide?

A

Inhibits resorption of sodium/potassium/chloride resulting in water lossRelaxes arterioles decreasing peripheral vascular resistance

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2
Q

When is hydrochlorothiazide used?

A

First line treatment for mild hypertension

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3
Q

What are side effects of thiazide diuretics?

A

HypokalemiaOrthostatic hypotensionHyperuricemiaCan elevate glucose & cholesterol

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4
Q

What is the MOA of furosemide?

A

Inhibit reabsorption of sodium in the loop of henle results in profound water loss (diuresis) & decreased cardiac output

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5
Q

When is furosemide used?

A

Treats hypertension due to fluid volume overload

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6
Q

What are side effects with furosemide?

A

HypokalemiaDehydrationHypotensionOtotoxicity

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7
Q

What is the normal potassium level?

A

3.5 - 5 mmol/L

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8
Q

What is the MOA of spironolactone?

A

Block the action of aldosterone resulting in potassium retention and excretion of sodium and water

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9
Q

When is spironolactone used?

A

Usually with other diuretics for increased effect with retention of potassium

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10
Q

What are side effects with spironolactone?

A

HyperkalemiaDeepened voice, impotence, hirsutism

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11
Q

What is the MOA of ACE inhibitors such as Captopril and Lisinopril?

A

Blocks angiotensin-converting enzyme thereby inhibiting production of angiotensin-2

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12
Q

What are side effects of lisinopril?

A

HypotensionDry, nonproductive, persistent coughDizzinessRashAngioedema

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13
Q

What is the MOA of losartan?

A

Blocks the action of angiotensin-2 after it is formed causing vasodilation and increased water & sodium secretion

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14
Q

What are side effects of angiotensin receptor blockers?

A

AngioedemaDo not use if pregnantUse with caution with renal problems

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15
Q

How are calcium channel blockers used to control blood pressure?

A

Blocking calcium channels causes vasodilation (the ipines)

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16
Q

What are the side effects with nifedipine?

A

Drop in blood pressureHeadachePeripheral edemaAbdominal discomfort

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17
Q

What is the MOA of hydralazine?

A

Relaxes smooth muscles of arteries and veins

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18
Q

What are side effects of hydralazine?

A

HypotensionDizzinessHeadacheTachycardiaEdemaGI upset

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19
Q

MAO of metoprolol, propranolol, carvedilol

A

Increases nitric oxide= vasodilation response Blocks stimulation of beta-1 receptors= Decreases HR and contractility

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20
Q

Side Effects of Beta-Blockers

A

Fatigue/lethargyBradycardiaHypotension Can mask hypoglycemia- prevents tachycardia, be careful with use in diabetics

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21
Q

Nursing Implications of Beta-Blockers

A

Recognize the RISK for hypotension and/or bradycardiaHold & contact provider if HR is less than 60 or a systolic BP less than 100

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22
Q

MAO of Clonidine (catapress)

A

Decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (both alpha AND beta receptors) Main outcome: decreased blood pressure

23
Q

Side Effects of Clonidine

A

Drowsiness- most common Give at night to combat this Rebound HTN May worsen pre-existing liver disease

24
Q

Nursing Implications of Clonidine

A

Do not abruptly discontinue- rebound HTN

25
Q

MAO of Doxazosin (cardura)

A

Selective alpha-1 blockade Venous AND arterial dilation

26
Q

Side Effects of Doxazosin (cardura)

A

hypotension, dizziness

27
Q

MOA of Ace Inhibitors- lisinopril, captopril

A

Blocks angiotensin-converting enzyme (ACE) Inhibits production of Angiotensin-2 (powerful vasoconstrictor) Inhibits aldosterone secretion- less water retention

28
Q

Side Effects of lisinopril/captopril

A

Dry, nonproductive, PERSISTENT cough- (largest complaint from patients often reason people switch)Dizziness Rash Serious: ANGIOEDEMA

29
Q

Can you take lisinopril, captopril while pregnant?

A

NO

30
Q

Nursing Considerations for lisinopril/captopril

A

Renal insufficiency- use cautiously in patients with history of renal diseaseCaptopril can cause neutropenia- monitor WBC Risk of hyperkalemia especially if patient on potassium supplements

31
Q

MOA of Losartan (cozaar)

A

blocks the action of angiotensin 2 AFTER it is formedCauses vasodilation Increased sodium and water excretion

32
Q

Side Effects of Losartan (cozaar)

A

(Well tolerated)Some risk of angioedema

33
Q

Can you take Losartan while pregnant?

A

NORequires the use of contraception if of childbearing age

34
Q

Nursing Implications of Losartan (cozaar)

A

Use cautiously in patients with renal problems

35
Q

MOA of Aliskiren (tekturna)

A

Direct inhibition of renin Induces vasodilation, decreases blood volume, decreases SNS, and inhibitors cardiac and vascular hypertrophy

36
Q

Side Effects of Aliskiren (tekturna)

A

relatively well tolerated GI discomfort When given with ACEi watch for hyperkalemia, especially in patients with diabetes

37
Q

Nursing Considerations of Aliskiren (tekturna)

A

Take several weeks to see full effect (half-life) DO NOT take pregnant

38
Q

Calcium Channel Blockers

A

nifedipine (procardia)nicardipine (cardene)verapamil (calan)diltiazem (cardizem)

39
Q

Side Effects of Calcium Channel Blockers

A

Orthostatic hypotension Peripheral edema

40
Q

Nursing Implications for CCB

A

CCB are often best for elderly and African Americans Diuretics can be given for peripheral edema

41
Q

MAO of Hydralazine (apresoline)

A

Vasodilators work directly on arterial and venous smooth muscles and cause relaxation Direct vasodilation cause decreased systemic and peripheral vascular resistance

42
Q

Side Effects of Hydralazine (apresoline)

A

HYPOTENSION Dizziness, headache, tachycardia, edema, dyspnea, GI upset

43
Q

MAO of Hydrochlorothiazide [HCTZ] (HydroDiruil)

A

-Works on the distal convoluted tubule to inhibit resorption of sodium/potassium/ & chloride = decreased cardiac output-Results in water loss Also relaxes arterioles = decreased peripheral vascular resistance (PVR)

44
Q

Side Effects of Hydrochlorothiazide

A

-Electrolyte and metabolic disturbances-HYPOKALEMIA (low potassium) -Orthostatic hypotension -May worsen renal insufficiency -Hyperuricemia- watch out with gout patients -Can elevate levels of glucose, cholesterol, and triglycerides

45
Q

Nursing Implications of Hydrochlorothiazide

A

-Can give potassium supplements -Encourage food rich in potassium

46
Q

MAO of Furosemide (Lasix)

A

-Inhibit the kidneys ability to reabsorb sodium in the LOOP OF HENLE -Makes kidneys put more sodium in the urine-WATER FOLLOWS SODIUM= more peeing out

47
Q

Loop Diuretic

A

Furosemide (Lasix)

48
Q

Side Effects Furosemide

A

-HYPOKALEMIAAnd other electrolyte abnormalities-Dehydration -Hypotension -Ototoxicity = difficulty hearing, usually transient with furosemide

49
Q

Nursing Implications of Furosemide

A

-Monitor potassium levels!-Patients typically receive KCL supplements with their Lasix doses

50
Q

Potassium-Sparing Diuretics

A

Spironolactone (Aldactone)

51
Q

MAO of Spironolactone (Aldactone)

A

Block the action of aldosterone (sodium & water retention)= potassium retention & excretion of sodium and water

52
Q

Side Effects of Spironolactone

A

Can see HYPERkalemia Endocrine effects: deepened voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism

53
Q

Nursing Implications of Spironolactone

A

-Only given PO -Usually given in combination with other hypertensives/diuretics to get more effect with a lower chance of hypokalemia -Only provides small amount of diuresis and hypotensive effect

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