Hypertension

Question 0

What is the mechanism of action for Hydrochlorothiazide?

Answer 0

Decreases plasma volume, extra cellular fluid volume, decreases peripheral vascular resistance.
Stops the reabsorption of h2o and Na

Question 1

What classification is Hydrochlorothiazide( hCTZ, Hydrodiuril)

Answer 1

Diuretic

Question 2

What are the side effects of Hydrochlorothiazide?

Answer 2

Polyuria, depletion of K+, occasional orthostatic hypotension, HA-dehydration

Question 3

What are the nursing implications for Hydrochlorothiazide?

Answer 3

Check BP before taking,
assess Lytes especially for hypokalemia.
I and O.
BUN and Creat

Question 4

What classification is lisinopril(prinivil, zestril)?

What is the mechanism of action?

Answer 4

ACE inhibitor, angiotensin converting enzyme inhibitor
Prevents the conversion of angiotensin I to angiotensin II(a potent vasoconstrictor). RAAS system
Reduces peripheral arterial resistance, BP, after load, PVR, decreases the heart size,increases CO.

Question 5

What is lisinopril used for?

Side effects?

Answer 5

Tx hypertension, tx of acute MI
-Decreased BP, angioedema( vessels irritated and red,puffy face)
Hyperkalemia
Dry hacking cough at night

Question 6

What are the nursing implications for the use of lisinopril ( prinivil, Zestril)

Answer 6

Check BP, apical pulse before each dose. 
VS
Renal function
Lytes
Take on an empty stomach
what OTC meds

Question 7

What classification and mechanism of action is losartan potassium(Cozar)?

Answer 7

Anti hypertensive

Potent vasodilator,blocks the effects of angiotensin II, decreases peripheral resistance, decreases blood pressure.

Question 8

What is losartan potassium (Cozar) used for?

Side effects?

Answer 8

Hypertension, relaxes blood vessels, decreases after load
SE- decreased BP, orthostatic hypotension,
Increased K+

Question 9

What are the nursing implications for losartan potassium (Cozar)?

Answer 9

Get a BP and apical pulse before administration,must be>100systolic
VS,
Weight
Lytes
don’t take OTC cold meds
Results can take 2-6 weeks to see….be patient.

Question 10

What classification and mechanism of action is amlodipine (Norvasc)?

Answer 10

Ca+ channel blocker,
Blocks Ca+ from going into cells which increases vascular Ca+. This relaxes vessels =Dilates coronary arteries, peripheral arteries.
Decreases SVR which decreases after load.

Question 11

What is the use for amlodipine (Norvasc)?

Answer 11

Manage hypertension,chronic stable angina

Question 12

What are the side effects of amlodipine?

Answer 12

Peripheral edema, low BP,

Facial edema, HR changes (tachy or Brady) postural hypotension, palpitations.

Question 13

What are the nursing implications of amlodipine (Norvasc)?

Answer 13

Check BP
Check HR
Check wt
Avoid grapefruit 
Systolic BP > 100 before giving meds

Question 14

What is the classification and mechanism of action is metropolol (
lopressor)?

Answer 14

Beta blocker-parasympathetic-rest and digest
Decreases SVR by vasodilation- relaxes smooth muscle,
Decreases HR which will decrease CO.

Question 15

What is the use and side effects of metropolol (lopressor)?

Answer 15

SE: diminished sexual, low BP, bradycardia,
Can cause heart block
Bronchospasm( doing the opposite as albuterol-B2 agonist)

Question 16

What are the nursing implications of metropolol ?

Answer 16

Assess for paradoxical reactions,(shoot BP up high fast)
Check HR and BP
Caution with respiratory pts( bronchospasm)
Don’t stop it rapidly
Don’t give if HR is < 60
If given IV it is a high alert drug
Systolic BP must be > 100 for all meds

Question 17

What is DASH?

Answer 17

Dietary approaches to stop hypertension.

Rich in fruits, vegetables,low fat dairy, lean meats reduced salt and sweets

Question 18

What are the factors that contribute to normal regulation of blood flow?

Answer 18

Adequate blood volume
Ability of the heart to effectively pump (CO)
Vascular tone SVR

Question 19

What is the formula for blood pressure?

Answer 19

BP= CO x SVR

Question 20

What is the formula for CO?

Answer 20

HR x SV ( stroke volume)

Question 21

What is SVR?

Answer 21

The resistance of blood flow created by the constriction or dilation of the systemic blood vessels.
Vasoconstriction- increase SVR
Vasodilation -decrease SVR

Question 22

What are the factors that control BP?

Answer 22

Baroreceptors in the arch (B1)
Sympathetic nervous system
Renin angiotensin aldosterone system