Hypertension

Question 1

What causes Primary Hypertension?

Answer 1

causes unknown
risk factors: genetics, hyperlipidemia, ethnicity, diabetes, obesity, age, stress, smoking, alcohol

Question 2

What causes Secondary Hypertension?

Answer 2

medications
renal or endocrine cause

Question 3

What are some HTN related diseases?

Answer 3

Heart failure
MI
CVA
Kidney failure
Retinopathy

Question 4

Non-Pharmacological Treatments for HTN?

Answer 4

Diet
Exercise
Weight
Quit Tobacco
Decrease alcohol
Stress reduction

Question 5

What drugs treat HTN?

Answer 5

Diuretics
ACE
Angiotensin 2 Receptor Blockers
Calcium Channel Blockers

Beta-andrenergic antagonists
Alpha 1 adrenergic antagonists
Central acting alpha 2 adrenergic agonists
direct acting vasodilators

Question 6

How do thiazide diuretics work?

Answer 6

pushing out Na from distal tubule and keeping it out, therefore water follows

Question 7

What is the name of a thiazide diuretic?

Answer 7

hydrochlorothiazide (HCTZ)

Question 8

Contraindications for HCTZ?

Answer 8

hypokalemia
anuria (failure to produce urine)
pregnancy and lactation

Question 9

Side effects of HCTZ?

Answer 9

hypotension
headache
hypokalemia
hyperuricemia (gout attacks)

Question 10

What do you monitor while on HCTZ?

Answer 10

serum drug levels of other meds (digoxin)

Question 11

When should you take HCTZ?

Answer 11

MORNING

Question 12

What is the angiotensin-converting enzyme inhibitor? (ACEIs)

Answer 12

lisinopril

Question 13

What is the angiotensin 2 receptor blockers? (ARBs)

Answer 13

losartan

Question 14

What combines to make Angiotensin 1?

Answer 14

Angiotensin and Renin

Question 15

What combines to make Angiotensin 2?

Answer 15

Angiotensin 1 and ACE

Question 16

What does Angiotensin 2 do?

Answer 16

Increase in aldosterone production: fluid increases in blood due to reabsorption of Na+

Question 17

What do ACE inhibitors do?

Answer 17

prevents conversion of angiotensin 1 to angiotensin 2
decrease blood pressure

Question 18

Most common side effect of lisinopril?

Answer 18

cough

Question 19

What are contraindications of lisinopril?

Answer 19

women of reproductive age (teratogens)
history of angioedema
african americans

Question 20

Nursing considerations for lisinopril?

Answer 20

hold if systolic BP <90
monitor potassium and sodium
monitor ambulation
Avoid NSAIDS

Question 21

MOA of losartan?

Answer 21

blocks angiotensin 2 from acting on target organs and tissues

Question 22

Contraindications of losartan?

Answer 22

pregnancy and lactation
hypotension

Question 23

Side effects of losartan?

Answer 23

hypotentions
headache
TERATOGEN

Question 24

What do calcium channel blockers do?

Answer 24

inhibit calcium ion movement across cardiac and arterial muscle cell membranes
(VASODILATION)

Question 25

What is the most common calcium channel blocker?

Answer 25

nifedipine

Question 26

Contraindications to nifedipine?

Answer 26

bradycardia
Acute MI, heart failure

Question 27

Side effects of nifedipine?

Answer 27

headache
peripheral edema

Question 28

What are the potential interactions with nifedipine?

Answer 28

no grapefruit juice
alcohol
increases serum digoxin levels

Question 29

MOA of metoprolol?

Answer 29

competes with SNS neurotransmitters at adrenergic receptors in cardiac muscle

Question 30

What time of med is metoprolol?

Answer 30

Beta Blocker

Question 31

Therapeutic effects of metoprolol?

Answer 31

decreased BP
decreased HR
decreased cardiac output

Question 32

Contraindications to metoprolol?

Answer 32

bradycardia
severe hepatic disease
asthma

Question 33

Side effects of metoprolol?

Answer 33

nausea, vomiting, heartburn
bradycardia
impotence, and decreased libido
MI if drug is abruptly stopped (MUST WEAN)

Question 34

Nursing considerations for metoprolol?

Answer 34

hold med if AP<60
hold med if BP<90
monitor DM blood glucose for hypoglycemia
monitor kidney and liver function and CBC