Chapter 22: Drugs Used to Treat Hypertension

Which medication lowers blood pressure by directly inhibiting renin?

Aliskiren (Tekturna)

The nurse has provided information to a patient with diabetes who has been prescribed a beta-adrenergic blocker. Which statement by the patient indicates a need for further teaching?

"If I get dizzy, I will stop taking the medication."

A patient asks the nurse how amlodipine (Norvasc) works to reduce the blood pressure. Which response will the nurse provide?

"It causes blood vessel dilation."

A patient who has just begun taking an angiotensin converting enzyme (ACE) inhibitor calls the nurse and reports feeling very dizzy when standing up and asks if the medication should be discontinued. What is the nurse's best response?

"Rise to a sitting or standing position slowly; your symptoms will resolve."

A patient's blood pressure is 134/78 mm Hg. The nurse records the pulse pressure as

56.

If blood pressure is 120/70, what is the MAP?

86.66

Which statement(s) about diuretics is/are true? (Select all that apply.)

A mechanism of action for the antihypertensive effects of diuretics includes volume depletion. They have been shown to reduce cardiovascular morbidity associated with hypertension. Electrolytes must be evaluated periodically for patients on loop diuretics.

Which complication(s) is/are associated with uncontrolled hypertension? (Select all that apply.)

Angina Stroke Renal failure Heart failure

Which medication is often administered with hydralazine to reduce reflex physiologic responses to the drug?

Beta blockers

Which class of antihypertensive agents should be avoided by patients with asthma?

Beta-adrenergic blocking agents

Which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a patient is taking is effective?

Blood pressure has decreased.

The nurse is preparing to assess blood pressure on a patient who has had two prior readings of 160/100. Physician's notes from a prior visit indicate that the patient is suspected to have hypertension. When reassessing this patient for hypertension, the nurse will do what? (Select all that apply.)

Choose a cuff encircling at least 80% of the arm. Support patient's arm at heart level. Encourage patient to sit quietly for 5 minutes before assessing blood pressure.

The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. Which is an adverse effect of this medication?

Chronic cough

Which statement(s) concerning the use of antihypertensive therapy for the treatment of hypertension would be considered true? (Select all that apply.)

Diuretics are the most commonly prescribed antihypertensive agent. Diuretics are often prescribed in combination therapy with other antihypertensive agents.

A patient recently prescribed felodipine (Plendil) for treatment of hypertension is experiencing dizziness when rising to a standing position. Which action will the nurse take?

Encourage the patient to sit down if feeling faint.

The nurse is finished conducting nutritional education with a patient about the DASH (dietary approaches to stop hypertension) diet. The patient would like to complete the breakfast menu for tomorrow. Which foods offered for breakfast would be most appropriate for the patient to choose? (Select all that apply.)

Grapefruit Orange juice Oatmeal

Which common adverse effect of an angiotensin II receptor antagonist will the nurse expect to assess in a patient?

Headache

The nurse instructs the patient to avoid the sudden discontinuation of beta-adrenergic blockers so as to avoid which symptom?

Increased angina

Which is true about postural hypotension during therapy with direct vasodilators?

It gradually resolves with continued medication use.

How does propranolol (Inderal) control hypertension?

Reduces the sympathetic stimulation in cardiac muscle

Hydralazine, a direct vasodilator, is used to treat hypertension associated with which condition?

Renal disease

Which physiologic response will the nurse expect to assess in patients taking hydralazine (Apresoline)?

Tachycardia

What is mean arterial pressure (MAP)?

The average pressure throughout each cycle of the heartbeat

The nurse is explaining to a patient how ACE inhibitors affect blood pressure. Which statement accurately describes the action of these medications?

They inhibit vasoconstriction.

Which agents are preferred for the initial treatment of hypertension?

Thiazide diuretics and beta-adrenergic blockers

Prior to the administration of a beta-adrenergic blocker, the nurse notes the patient to have a heart rate of 52 beats/min, peripheral edema, crackles in the bases of the lungs, and mottled skin. Which is the priority nursing action?

Withhold the medication and notify the health care provider.

When displayed by the patient, which symptom would be most indicative to the nurse to withhold a recently prescribed beta-adrenergic blocker?

Wheezing