NUR 114 - Hypertension Medications EXAM III

Question 1

hydrochlorothiazide, furosemide, spironolactone and amiloride

Answer 1

examples of diuretics

Question 2

Action: 
promotes sodium and water excretion, reduces plasma volume, decrease sodium in the arteriolar wall, and reduces the vascular response to catecholamine's.
Nurses Monitor:
-intake and output 
-vital signs
-daily weight
-electrolytes
-orthostatic hypotenison
-weakness/dizziness
-sexual dysfunction

Answer 2

Diuretics

Question 3

Decrease the heart rate by widening the veins and decreases the force of contraction and cardiac output. Before administration check the HR. Do not give if HR is <50-60 bpm, and hold if systolic BP is <90-100.

Answer 3

Beta Adrenergic Blockers

Question 4

Side effects:
orthostatic hypotension
bradycarida
weakness 
fatigue
depression 
and sexual dysfunction
(can cause confusion and disorientation in the elderly)

Answer 4

Side effects of Beta Adrenergic Blockers

Question 5

what medicine is best for African Americans and elderly patients?

Answer 5

calcium channel blockers

Question 6

Action:
increases sodium excretion and decreases calcium levels. promotes vasodilation by preventing movement of extra cellular calcium into cells, thus decreasing demand for oxygen and lowering peripheral resistance thus the BP.
-dry mouth is a common side effect
-monitor BP and HR 
-alert doctor of swelling of feet and hands. 
-avoid grapefruit juice. 
SIDE/ADVERSE EFFECTS:
-GI problems
-bradycardia
-headaches
-constipation
-peripheral edema

Answer 6

calcium channel blockers

Question 7

ACTION:
relaxes blood vessels and allows them to dilate. prevents the conversion of angiotensin I to angiotension II. Doesn't really work well in African Americans. Renal and kidney function should be assessed and monitored. 
SIDE EFFECTS:
-persistent dry cough
-hyperkalemia
-decreased renal function

*administer medication while the patient is lying down or sitting down to prevent sudden drop in BP.

(avoid foods high in potassium since this is a potassium sparing drug)

Answer 7

Angiotensin Converting Enzyme (ACE)

distinguished by “pril”

Question 8

ACTION:
blocks binding angiotensin II to receptor sites, resulting in vasodilation. One should avoid food high in potassium. May have severe leg cramps if too much potassium. often known as ACE without the cough.
NURSING INDICATIONS:
-check for BP prior to giving
-St. Johns Wort and grapefruit juice can increase absorption of this drug. so avoid.

Answer 8

Angiotension II Receptor Blocker (ARBs)

distinguished by “tan”

Question 9

ACTION:
Very potent quick acting IV drugs which relax smooth muscles of blood vessels causing vasodilation and reducing systemic vascular resistance. 
EXAMPLES: 
-nitroprusside 
-Hydralazine
-Minoxidil

Primarily used for severe hypertension/hypertensive crisis

• increases blood flow to kidneys and brain.
• nurses must monitor BP and apical pulse during entire IV administration.

Answer 9

Vasodilator