Chapter 50

Question 1

KEY DRUG CLASSES
-What 4 anti-HTN drug classes will we focus on?

Answer 1

1. Diuretics
2. ACE-I
3. CCBs
4. Beta blockers

Question 2

DIURETICS
-What are 3 types of diuretics?

Answer 2

1. Thiazide
2. Loop
3. Potassium-sparing

Question 3

DIURETICS: Thiazides
-What are these the first line therapy for?
-What are the two types

Answer 3

-Uncomplicated HTN
-Hydrochlorothiazide, chlorthalidone

Question 4

DIURETICS: Loop
-Example?

Answer 4

Furosemide

Question 5

DIURETICS: Potassium-Sparing
-Example

Answer 5

Spironolactone

Question 6

DIURETICS: Mechanism
-Explain what these diuretics do

Answer 6

-They promote sodium & water excretion from the kidneys
-By doing this, it decreases blood volume, which decreases CO AND as a result, reduces BP & peripheral vascular resistance

Question 7

DIURETICS: Nursing Action
-Which lab value do you want to check & why?

Answer 7

-Electrolytes!!
-There is a potential for loss of potassium or sodium

Question 8

DIURETICS: Nursing Action
-What will you monitor? (2)

Answer 8

1. BP
2. signs of dehydration (especially in older adults)

Question 9

BETA BLOCKERS
-What do beta blockers end in?
-What are the 3 types?

Answer 9

-olol
-Metoprolol, atenolol, propranolol

Question 10

BETA BLOCKERS: Therapeutic Uses
-Who is this used for?

Answer 10

Patients with HTN, CAD, & HF

Question 11

BETA BLOCKERS: Mechanism
-What do these medications do?
-What does this cause?

Answer 11

-They block beta-adrenergic receptors
-A decrease in HR & contractility, leading to reduced CO & BP

Question 12

BETA BLOCKERS: Mechanism
-Apart from blocking beta-adrenergic receptors, what else do they do?
-What does this do?

Answer 12

-Inhibit renin release from the kidneys
-Decreases RAAS activation

Question 13

BETA BLOCKERS: Adverse Effects
-What are the three? Remember BFB

Answer 13

-Bradycardia
-Fatigue
-Bronchospasm

Question 14

BETA BLOCKERS: IMPORTANT
-You should be VERY cautious with giving these medication to patients with what two conditions?
-Why?

Answer 14

-Asthma & COPD
-Because beta blockers can cause bronchoconstriction

Question 15

ACE INHIBITORS
-What do ACE-Is end in?
-What are 3 examples?

Answer 15

-pril
-Captopril, Enalapril, Lisinopril

Question 16

ACE INHIBITORS: Therapeutic Uses
-Who are these used for?

Answer 16

Patients with HTN, diabetes, HF, & chronic kidney disease

Question 17

ACE INHIBITORS: Mechanism
-What does this do?
-As a result, what does this cause?

Answer 17

-Blocks conversion of angiotensin I to angiotensin II
-Vasodilation, reduced aldosterone, & decreased sodium and water retention

Question 18

ACE INHIBITORS: Adverse Effects
-What is the most common effect that patients complain about?
-For this reason patients may…

Answer 18

-Persistent dry cough
-stop taking the medication bc it gets annoying

Question 19

ACE INHIBITORS: Adverse Effects
-What are 3 more serious effects? Remember AHH

Answer 19

-Angioedema
-Hyperkalemia
-Hypotension

Question 20

CALCIUM CHANNEL BLOCKERS
-What are 4 examples?

Answer 20

1. Almodipine
2. Nifedipine
3. Diltiazem
4. Verapamil

Question 21

CALCIUM CHANNEL BLOCKERS: Therapeutic Uses
-Who is this used for?

Answer 21

Patients with angina & certain arrhythmias

Question 22

CALCIUM CHANNEL BLOCKERS: Mechanism
-What do these medications do?

Answer 22

Block calcium entry into cardiac & vascular smooth muscle

Question 23

CALCIUM CHANNEL BLOCKERS: Mechanism
-What will they cause? (3)

Answer 23

Vasodilation of peripheral arteries, reduce cardiac workload, & lower BP

Question 24

CALCIUM CHANNEL BLOCKERS
-What specific things do verapamil & diltiazem do? (2)

Answer 24

1. Slow HR
2. Reduce myocardial contractility

Question 25

**NURSING ACTIONS** -What will you monitor? (2)

Answer 25

1. BP 2. Electrolytes & kidney function

Question 26

**NURSING ACTIONS** -What will you assess in terms of BP? -Why? -What should they not do? -What should they do?

Answer 26

-Orthostatic hypotension -It is common & puts them at risk for falls and dizziness -Operate automobiles -Change positions slowly

Question 27

**NURSING ACTIONS** -In terms of taking the medication, what 2 things will you check?

Answer 27

1. Medication adherence 2. Adverse drug effects

Question 28

**NURSING ACTIONS**: *Patient Education* 1. Take _______ EXACTLY as _____ 2. AVOID what? 3. Monitor ____ at home 4. Reduce ____ intake 5. ______ eating plan 6. Maintain ______ weight through ______ _____ 7. Limit _____ & stop _____ 8. _____-____ appointments

Answer 28

1. medications; prescribed 2. stopping medication abruptly 3. BP 4. sodium 5. DASH (diet approaches to stop HTN) 6. healthy; regular exercise 7. alcohol; smoking 8. Follow-up

Question 29

**NURSING ACTIONS**: *Patient Education* -Why should patients **NOT** stop the medication abruptly?

Answer 29

Because it can lead to uncontrolled BP & increased risk of complications