EDAPT: Perfusion

Use the drop-down menus to fill in the missing pharmacokinetic information of enalapril.

Drug: Enalapril Route: Oral (PO) Onset: 1 hour Peak: 4-8 hours Half-life: 2 hours Duration: 12-24 hours

A client with a diagnosis of heart failure has been started on a nitroglycerin patch by their healthcare provider. What should this client be taught to avoid?

Drugs to treat erectile dysfunction

Which calcium channel blockers are known as dihydropyridines and known to be more vascular selective? Select all that apply.

Felodipine Nifedipine Amlodipine

A client's laboratory test indicates high triglyceride levels but normal low- and high-density lipoproteins. Which medication class's primary mechanism of action reduces triglycerides?

Fibric acid derivatives​

Which antilipemic medication activates an enzyme to breakdown cholesterol?

Gemfibrozil

Routine oral hygiene is necessary to prevent which adverse effect associated with calcium channel blocker therapy?

Gingival hyperplasia

What drug decreases cholesterol production by the liver?

HMG coenzyme A reductase inhibitor

Which drug decreases the rate of cholesterol production?

HMG coenzyme A reductase inhibitor

__________ have an adverse effect of rhabdomyolysis.

HMG coenzyme A reductase inhibitors

In reviewing a client's medication list, the nurse understands that alirocumab is a medication for which antilipemic class?

PSCK-9 inhibitor​

Use the drop-down menus to complete the pharmacokinetic information for ivabradine.

Peak: 1 hour Half-life: 6 hr Duration: 12 hr

The initial nursing assessment of a client diagnosed with hypertension should include questions about which underlying causes? Select all that apply.

Pheochromocytoma Kidney disease Hepatic dysfunction

A client has a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. During a review of the client's list of current medications, which would cause concern for a possible interaction with this new prescription? Select all that apply.

Potassium supplement taken daily. Nonsteroidal anti-inflammatory drugs (NSAIDs) taken as needed for headaches. Opioid used for occasional severe pain.

Use the drop-down menus to fill in the missing information related to dosing of carvedilol.

Preparation: Carvedil Route: Oral Dose: 6.25-25 mg Frequency: Twice daily

The decision to start antilipemic therapy is based on which factors? Select all that apply.

Presence of atherosclerotic heart disease Elevated low-density lipoprotein levels​ Elevated ten-year risk of a heart attack or stroke​

By which mechanisms do angiotensin-converting enzyme (ACE) inhibitors cause systemic vasodilation and lower blood pressure? Select all that apply.

Prevent the breakdown of bradykinin. Stop the conversion of angiotensin I to angiotensin II.

Which antianginal medications belong to the classification of beta-adrenergic blockers? Select all that apply.

Propranolol Atenolol Metoprolol Nadolol

Adam (pronouns: he/him/his) has a history of stable angina. Answer each question about Adam's knowledge and experience with angina. Adam is getting ready to walk in a local park. Which preparations indicate that he understands self-care actions related to his health condition? Select all that apply.

Puts his rapid-acting antianginal medication in his pocket. Checks his cell phone charge level.

Which condition may result from stopping clonidine therapy abruptly?

Rebound hypertension

What is the overall treatment goal for a client taking atorvastatin?

Reduce the risk of vascular disease or events

Which beneficial cardiovascular effects are anticipated when metoprolol is used to treat heart failure? Select all that apply.

Reduced sympathetic nervous system stimulation. Reduced heart rate

A client taking antilipemic medication for hypercholesterolemia reports a change in urine color, muscle weakness, and fatigue. Which rare adverse reaction is the nurse concerned about?

Rhabdomyolysis​

Use the drop-down menus to fill in the missing information related to dosing of captopril.

Route: Oral (PO) Dose: 12.5-20 mg Frequency: 2-3 times daily Considerations: It may be increased by the provider to 150mg three times daily if indicated.

Use the drop down menus to fill in the missing information related to the dosing of ranolazine.

Route: Oral (PO) Dose: 500 mg Frequency: 2 times daily Considerations: May be increased to 1000 mg 2 times daily

Use the drop-down menus to fill in the missing information related to dosing of clonidine.

Route: Orally (PO) Dose: 0.2-0.6 mg Frequency: Daily Considerations: Divided doses Route: Transdermal patch (topical) Dose: 0.1-0.3 mg/24 hours Frequency: Weekly Considerations: Remove previous patch

Use the drop-down menus to fill in the missing information related to the pharmacokinetics of isosorbide dinitrate.

Route: PO extended-release (ER) Onset: 30 minutes Duration: Up to 12 hours

What is the route of administration for atorvastatin?

Oral

By __________ the systemic vascular resistance, calcium channel blockers decrease the __________ and myocardial demand for __________.

Decreasing Workload of the heart Oxygen

While assessing a client with angina who has a new prescription for selective beta-1 blocker therapy, the nurse is aware that the presence of which conditions may place this person at risk for complications? Select all that apply.

Diabetes mellitus Asthma

A nurse assesses an apical pulse of 35 and a blood pressure of 110/60 in a client before administering their chronic heart failure medications. Which medications should the nurse hold until speaking with the client's healthcare provider? Select all that apply.​

Digoxin​ Carvedilol​

The teaching plan for a client starting on long-acting nitroglycerin includes the drug's mechanism of action. The nurse teaches that this drug relieves chest pain by which action?

Dilating just the coronary arteries

Which calcium channel blockers are indicated for cardiac dysrhythmias? Select all that apply.

Diltiazem Verapamil

When teaching an individual with angina to administer translingual nitroglycerin during an acute anginal attack, which information regarding safety should be included?

Direct the spray carefully.

What mechanism of action do angiotensin II blocking medications (ARBs) stop (or block) to decrease blood pressure? Select all that apply.

Direct vasoconstriction Release of aldosterone

The goals of treatment for heart failure include preventing which outcomes? Select all that apply.

Disease progress Death Hospitalization

Use the drop-down menus to fill in the missing information related to the pharmacokinetics of nitroglycerin.

Route: SL Onset: 2-3 minutes Duration: 0.5-1 hour

Use the drop-down menus to fill in the missing pharmacokinetic information of clonidine.

Route: Transdermal Onset: 2-3 days Peak: Unknown Half-life: Unknown Duration: 7 days

Select the data collected by the nurse prior to administering the first dose of a prescribed antilipemic medication.​

Serum lipid levels Last bowel movement Known medication allergy

A client was recently prescribed a statin medication. The therapeutic effect of statin medications is a reduction in which value?

Serum low-density lipoprotein (LDL)

The nurse is caring for a hospitalized client with heart failure who is receiving captopril and spironolactone. Which laboratory value will be most important to monitor?

Serum potassium

Control of angina is achieved when the __________ and __________ of episodes decreases and the client's __________ increased activity occurs.

Severity Frequency Tolerance of

During a follow up visit with the healthcare provider, a person taking carvedilol reports the following information. Which indicates a possible complication due to the medicine?

Shortness of breath and wheezing with mild exertion.

Adam (pronouns: he/him/his) has a history of stable angina. Answer each question about Adam's knowledge and experience with angina. During his walk, Adam experiences chest pain similar to past anginal episodes. Which actions should he take now? Select all that apply.

Sit down right away. Take the antianginal as directed.

Some medications used to treat angina work by __________ the heart rate to allow the myocardial cells to __________.

Slowing Receive oxygen

Which medications are routinely used in heart failure treatment? Select all that apply.​

Spironolactone Furosemide Carvedilol Losartan

Which over-the-counter items should not be consumed by an individual taking ranolazine for unstable angina? Select all that apply.

St. John's Wort Grapefruit juice

HMG coenzyme A reductase inhibitors are also known as __________.

Statins

Alirocumab and evolocumab may be administered by which medication routes? Select all that apply.

Subcutaneous​

By what routes can isosorbide dinitrate be administered? Select all that apply.

Sublingual Oral

Select the routes by which nitroglycerin may be administered.

Sublingual tablet Intravenous Transdermal patch Oral Translingual spray Ointment

Atenolol is prescribed for angina. Which new assessment findings suggest further follow-up is required before administration of the medication?​ Select all that apply.

Swelling in bilateral lower extremities Crackles in lung fields Dyspnea

Which topics will the nurse include in discharge teaching for a client newly diagnosed with heart failure taking valsartan/sacubitril? Select all that apply.

Symptoms that heart failure is getting worse. How to check food labels for potassium and fat content. How to check and record weight daily. Date and time of next healthcare provider appointment.

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor after experiencing a myocardial infarction. What effects on the body will this medication achieve? Select all that apply.

Systemic vascular resistance and blood pressure will decrease. Kidneys will retain potassium. Kidneys will excrete water and sodium.

The nurse is caring for a client who has heart failure and has a new prescription for sacubitril/valsartan. Which client information is most important to discuss with the healthcare provider before administration of the medication?

Taking lisinopril 10 mg daily

A 43-year-old client is taking lisinopril 10mg twice daily. They mention that they are trying to get pregnant. Which statement is correct at this time?

The lisinopril should be substituted for something else during pregnancy.

A client, who was prescribed lisinopril 3 weeks ago, contacts the clinic reporting swelling of the lips, eyes, and tongue that started about 30 minutes ago. The nurse suspects these symptoms are related to __________ and recommends the individual __________.

The onset of angioedema Call 911 immediately

Which assessment data suggests that a client's chest pain is caused by stable angina?

The pain is relieved after the client takes nitroglycerin.

A client with a history of angina is prescribed nitroglycerin 0.4 mg sublingually up to three doses five minutes apart for anginal symptoms. The client is experiencing anginal symptoms and takes sublingual nitroglycerin to relieve chest pain ranked 6/10. Five minutes later, the chest pain is 4/10. What action should be taken next?

The person should take another sublingual nitroglycerine tablet.

The initial nursing assessment of a client diagnosed with angina should include questions about which underlying causes? Select all that apply.

Tobacco use Diabetes mellitus High blood pressure

The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of which condition?

Tolerance

The nurse expects which laboratory studies will be ordered for a client who has been taking simvastatin for six (6) months? Select all that apply.

Total cholesterol​ Triglycerides Liver function studies ​ High-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels

When providing hypertension screening and education, a healthcare professional shares that which medications are in the angiotensin II blockers (ARB) class? Select all that apply.

Valsartan Eprosartan Losartan

Phosphodiesterase inhibitors (PDIs) have an added advantage in treating heart failure. These drugs cause a positive inotropic effect and what other effect?

Vasodilation

A client with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina?

Vasospastic

A client with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina?

Vasospastic (Prinzmetal) angina​

Exogenous lipids come from __________.

Dietary intake

Use the drop-down menus to fill in the missing information related to dosing of sacubitril and valsartan.

Route: PO Frequency: Two times daily

Drag each medication to the classification in which it belongs.

*Benzothiazepines:* Diltiazem *Dihydropyridines:* Amlodipine Nifedipine *Phenylalkylamines:* Verapamil

While attending a community picnic on a hot day, an older adult experienced an episode of stable angina and took a sublingual nitroglycerin tablet which relieved the pain. Thirty minutes later, the individual experienced dizziness and hypotension and was brought to the first aid tent for care. After the client feels better and their blood pressure has returned to normal, what information will the nurse provide to help the client avoid a recurrence? ​

"Hot weather can increase the effects of your medication. Hydrate and limit your time outside on days like this."

The nurse volunteering at a community picnic on a hot, humid day is treating an older adult experiencing dizziness and hypotension. After the client is feeling better and their blood pressure has returned to normal, what information will the nurse provide to help the client avoid a recurrence?

"Hot weather can increase the effects of your medication. Try to limit your time outside on days like this."

An individual diagnosed with hypertension six months ago is frustrated that their blood pressure is still elevated despite having tried several medications. When asked what is taking so long, what is the best response by the healthcare provider?

"Hypertension is a complex disease with multiple causes, so it can take time to discover which medication, or combination of medications, works best for each person."

While caring for a client with hypertension who has recently started taking carvedilol, the client reports, "This medication seems to give me a rash." Which statement provided by the healthcare provider is best?

"I am glad you mentioned this. Does this rash itch or hurt?"

A client is prescribed nitroglycerin 0.4 mg sublingually up to three doses five minutes apart for anginal symptoms. Which statements suggest more client education is needed? Select all that apply.

"I can keep taking these until the pain goes away, I don't need to stop at three doses." "Taking sublingually means I should put it on my tongue and swallow it." "I can take all three doses at once if the pain is bad."

Which statement by the client requires further medication education about extended-release forms of the calcium channel blocker diltiazem?

"I can take this drug to stop an attack of angina."

The nurse is providing discharge instructions to a client who will be taking carvedilol 12.5 mg twice daily at home for heart failure. Which statements made by the client demonstrate their understanding of the discharge instructions? Select all that apply.

"I have been walking every day and no longer smoke cigars. I am starting to enjoy exercise, but really do miss the cigars, though." "I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor." "I will avoid using salt substitutes that contain potassium."

The nurse has provided education to a client who is prescribed captopril. Which statement made by the client indicates further teaching is required?

"I take the first dose each day with breakfast, then space them out evenly until bedtime."

The nurse determines that a client who was recently prescribed simvastatin understands the dosing schedule when they make which statement?

"I take this at night since my liver processes lipids in the early morning hours."​

A client has been prescribed atorvastatin. Which statement indicates that more teaching is needed?

"I will be cured of my cholesterol problem."

After the nurse has finished teaching a client about the use of sublingual nitroglycerin, which client statement indicates that the teaching has been effective?

"I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes apart."

A client with diabetes, hypertension, and stable angina is being discharged home. The client will take a non-selective beta-blocker and insulin per sliding scale. Which statement by the client demonstrates they require additional education about the side effects of the beta-blocker?

"I will know when my glucose is low because my heart will be racing.​"

The nurse is providing diet education to a client with a history of heart failure. Which statement made by the client indicates they understand the diet teaching?

"I will limit my consumption of prepackaged frozen meals to those containing less than 1 gram of sodium."​

In preparation for discharge, the nurse teaches a client with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which client statement indicates that the teaching has been effective?

"I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."

Mr. James (pronouns: he/him/his), an older adult with hypertension and chronic kidney disease, is talking with a group of young men newly diagnosed with hypertension about coping with the diagnosis of a lifelong alteration in health. When a participant asks Mr. James what he would do differently if he had the chance, which statement from Mr. James reinforces the importance of medication compliance?

"I would have started taking antihypertensives when my healthcare provider first said I needed them."

Which statement by the client indicates a need for further education about atorvastatin?​

"If I eat a low-cholesterol meal today, I can skip the medicine."

An individual asks how diltiazem works to help angina. What is the best response by the health professional?

"It blocks calcium channels causing the arteries to dilate."

The nurse is counseling a client who is starting to take amlodipine for angina. Which statement by the client indicates that further teaching is needed?

"It is important that I take this medication on an empty stomach."

A client is prescribed metoprolol for chronic angina. Which statement by the client indicates the need for additional client medication teaching?

"It is safe to stop this medication abruptly without tapering the dose down.​"

A hypertensive client who has been prescribed captopril states, "The doctor keeps changing my pills and none are working. I feel like a guinea pig." Which response by the nurse would be most appropriate?

"It often takes a while before the right medication is found."

Which statements by a client provide subjective data that the recently prescribed isosorbide dinitrate is having the desired therapeutic effect? Select all that apply.

"Last night, I realized I had not taken any sublingual nitroglycerin throughout the day instead of the 2-3 times I'd been averaging." "I was able to walk around the block twice last night with my partner. First time in years we've done that."

For each condition below, select the indications for the use of carvedilol and/or clonidine. Note that some condition(s) may apply to more than one medication.

*Carvedilol:* Hypertension Heart failure Left ventricle dysfunction *Clonidine:* Attention-deficit hyperactivity disorder (ADHD) Hypertension Opioid withdrawal

The nurse providing client education about cholestyramine will include which statements in the education? Select all that apply.

"Notify the healthcare provider if your stool becomes frothy or foul smelling." "It can be mixed with water, milk, juice, or another noncarbonated beverage." "This medication should be taken before meals." "It is still important to follow a low-fat, low-cholesterol diet."

Which statement by the client on long-term antilipemic therapy indicates the need for further education?

"Once my cholesterol levels are normal, I can stop the medication."

A client called the clinic to report blood in the urine and muscle soreness three (3) months after starting atorvastatin. How should the nurse respond?

"Stop your atorvastatin and come to the clinic in the morning."

A client who has a prescription for methyldopa is being tapered off the medication. The nurse includes which statement in the client teaching?

"Stopping this medication suddenly can be very dangerous, so it is important that you follow the taper schedule carefully."

A client has started taking niacin (nicotinic acid) for hypercholesterolemia. After the first dose, the client experiences facial redness and tingling with a feeling of being hot. The client asks what may be causing this. What is the nurse's best response?​

"This is a common side effect of this medication."​

The nurse is advising a client whose triglyceride levels remain elevated despite three months of following a low-fat, low-cholesterol diet. The client is started on omega-3 acid ethyl esters. Which statements would the nurse include in the teaching? Select all that apply.

"This medication is commonly available over the counter."​​ "You should follow a low-fat diet while you're taking this medication."​​ "It is important to establish an exercise routine that works with diet and medication to control your cholesterol."​​

A client has a history of heart failure. Which statements by the client indicate the client may not be adhering to their prescribed medication regimen?​ Select all that apply.

"While I sleep, I have to prop myself up with a pillow so I can breathe." "My shoes are tighter than they were last week." "I've noticed that I've gained six pounds in one week."

A client calls the healthcare provider at 2 p.m. stating, "I forgot to take my daily blood pressure pill at 8 a.m. like I usually do. Should I take it now?" Which response provided by the healthcare provider is best?

"Yes, it is important to take the medication each day."

The healthcare provider has ordered fenofibrate daily. The client also takes warfarin and a multivitamin daily. What information should the nurse include in the teaching?​

"You may need more frequent testing of your prothrombin time."

Indicate which listed side/adverse effects may be caused by the listed antihypertensive medication class by placing a check in the appropriate column. Each side effect may be caused by more than one drug.

*Alpha-1 Blockers:* Headaches Dizziness *Angiotensin II Receptor Blockers (ARBs):* Angioedema Headaches Dizziness *Vasodilators:* Headaches Dizziness

Drag the medications to the classification in which each belongs.

*Alpha-1 Blockers:* Terazosin Doxazosin *Angiotensin II Receptor Blockers (ARBs):* Valsartan Losartan *Vasodilators:* Minoxidil Diazoxide

Match the medication to the class in which it belongs.

*Alpha-2 Adrenergic Stimulators:* Methyldopa Clonidine *Dual-Action Alpha-1 & Beta Receptor Blockers:* Carvedilol Labetalol

Place each antilipemic drug into the correct class. ​

*HMG Coenzyme A Reductase Inhibitors:* Lovastatin Simvastatin *Bile Acid Sequestrants​:* Cholestyramine Colesevelam *Fibric Acid Derivatives​:* Gemfibrozil Fenofibrate

For each medication or over-the-counter product, indicate which drug interaction(s) it can cause when administered with losartan. Note that each interaction may support more than one medication or over-the-counter product.

*Increased Hypotension:* Nonsteroidal anti-inflammatory drugs (NSAIDs) Angiotensin converting enzyme (ACE) inhibitors *Renal Dysfunction:* Nonsteroidal anti-inflammatory drugs (NSAIDs) Angiotensin converting enzyme (ACE) inhibitors *Hyperkalemia:* Potassium supplements

For each medication or over-the-counter product, indicate if it causes increased hypotension or decreased drug effectiveness when administered with doxazosin.

*Increased Hypotension:* Sildenafil Alcohol *Decreased Effectiveness:* Estrogens Nonsteroidal anti-inflammatory drugs (NSAIDs)

Use the drop-down menus to fill in the missing information related to the pharmacokinetics of metoprolol.

*Oral (PO):* Onset: 15 minutes Duration: 6-12 hours *Oral Extended Release (PO-ER):* Duration: 24 hours *Intravenous (IV):* Duration: 5-8 hours

Use the drop-down menus to fill in the missing information related to the pharmacokinetics of verapamil.

*Route: Oral (PO)* Onset: 1-2 hr Peak: 30-90 min Half-life: 4.5-12 hr Duration: 3-7 hr *Route: Oral (PO) - Extended-Release (ER)* Onset: Unknown Peak: 5-7 hr Half-life: 4.5-12 hr Duration: 24 hr *Route: Intravenous (IV)* Onset: 1-5 min Peak: 3-5 min Half-life: 4.5-12 hr Duration: 2 hr

Complete each sentence by selecting the word or phrase that makes the sentence true from the drop-down menu. 1. Drugs in the __________ class include losartan, olmesartan, and valsartan. 2. Drugs in the __________ class include hydralazine, diazoxide, and minoxidil. 3. Drugs in the __________ class include doxazosin, prazosin, and terazosin.

1. Angiotensin II receptor blockers (ARBs) 2. Vasodilators 3. Alpha-1 blockers

A client who started 2 months ago on an antihypertensive is in the clinic for follow-up. The systolic blood pressure reading of __________ millimeters of mercury (mmHg) and a diastolic blood pressure reading of __________ mmHg, with no symptoms or adverse reactions would meet the blood pressure goals for this client.

115 62

Use the drop-down menus to fill in the missing information related to the dosing of metoprolol.

2 times Daily

Use the drop-down menus to fill in the missing information related to the pharmacokinetics of ranolazine.

2-5 hours 7 hours 12 hours

The average number of older adults dying from heart failure one year after diagnosis is __________.

33%

Which individual would benefit most from an angiotensin-converting enzyme (ACE) inhibitor?

50-year-old female with systolic dysfunction heart failure.

In which individual should clonidine be used with caution?

87-year-old with heart failure and hypertension.

Which individuals may require a lower dose of amlodipine? Select all that apply.

A 49-year-old diagnosed with aortic stenosis A person with chronic cirrhosis A 79-year-old with vasospastic angina

Which client living with heart failure is most at risk for exacerbation of the disease?

A client who reports not taking amiodarone for one month and experiencing atrial fibrillation.

An individual taking carvedilol for the last three weeks is reporting an increasingly dry mouth, unusual issues with constipation, and becoming extremely dizzy within 5 minutes of jogging for exercise. When asked, the person confirms that these symptoms started after the medication dosage was increased. The healthcare provider suspects __________ as the reason for the current symptoms and recommends the individual __________.

A drug-to-drug interaction Contact prescribing provider

The nurse is reviewing drug interactions with a male client who has a prescription for isosorbide dinitrate as treatment for anginal pain. Which substances could result in a drug-to-drug interaction? Select all that apply.

A glass of wine Erectile dysfunction medication Carvedilol

In which individuals should caution be used when administering isosorbide dinitrate? Select all that apply.

A middle-aged adult who is dehydrated. An older adult experiencing chest pain for the first time. An individual having a heart attack involving the right ventricular muscle.

Which conditions can long-term antilipemic therapy cause​? Select all that apply.

Alteration in vitamin absorption Constipation Biliary issues

Which statements about hypertension in the United States are supported by facts? Select all that apply.

An estimated 31 million adults taking medication for high blood pressure are not taking the right dose. Most adults with hypertension do not have their hypertension under control. About 30 million adults with known hypertension are not being treated.

While reviewing the medication list for a newly admitted client, the nurse notes the client is taking a calcium channel blocker. Based on knowledge of the medication, the nurse inquires if the client has a history of which conditions? Select all that apply.

Angina pectoris Cardiac dysrhythmia​ Hypertension

A stable client prescribed valsartan/sacubitril appears to have trouble talking and states their tongue feels larger than normal. The nurse suspects which known adverse reaction to this medication?​

Angioedema​

Which antihypertensive medications are contraindicated during pregnancy and lactation? Select all that apply.

Angiotensin converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs)

Match each medication to the classification in which it belongs.

Angiotensin-converting enzyme (ACE) inhibitors - Captopril Angiotensin II receptor blockers (ARBs) - Valsartan Beta-blockers - Carvedilol Loop diuretics - Furosemide Aldosterone inhibitors - Spironolactone

When giving antihypertensive drugs, the nurse will consider giving the first dose at bedtime for which class of drugs?

Angiotensin-converting enzyme (ACE) inhibitors, such as captopril

Which medication class has a known side effect of a dry cough caused by increased bradykinin levels?

Angiotensin-converting enzyme inhibitors

Which medication classes are commonly used in the treatment of heart failure? Select all that apply.

Angiotensin-converting enzyme inhibitors Loop diuretics Beta-blockers​

The nurse would question the use of milrinone in a client with which condition?

Aortic valve regurgitation

What precaution does the nurse take to protect themselves when preparing and administering nitroglycerin ointment?

Apply gloves before administration.

In addition to angina, for what conditions are calcium channel blocker medications indicated? Select all that apply.

Arrhythmia Hypertension

While obtaining subjective assessment data from a client with hypertension whose blood pressure has not reached goal after three months of therapy, the nurse asks the client about changes they have made to their diet and exercise. What is the rationale for this question?

Assess client's adherence to recommended lifestyle changes.

An hour after administering the daily dose of an antihypertensive to a 64-year-old client, the nurse asked to help them to the bathroom. What priority action will the nurse take before completing the request?

Assess the orthostatic blood pressure

A client has received hydralazine and isordil dinitrate for chronic heart failure. What is a nursing priority for this client while assisting them to the bathroom?​

Assist the client up slowly and gradually.

The nurse is reviewing the home medication list for a client with identified hypercholesterolemia. The client reports taking ezetimibe daily. The nurse understands this medication is designed to reduce the client's risk of which condition?​

Atherosclerosis​

The nurse prepares discharge teaching for a client receiving isosorbide dinitrate for treatment of angina. What information to lower potential side effects of the medication will the nurse include?

Avoid alcohol consumption.

Which medical conditions are considered contraindications for antianginal therapy? Select all that apply.

Cardiogenic shock Hypotension Second-degree atrioventricular (AV) block without a pacemaker

Which priority assessments should be completed before administering antilipemic medication to a client? Select all that apply.

Baseline vital signs​ Current medication list Known allergies​ Last bowel movement​

What is the ideal time for a client to take atorvastatin?

Before bedtime

When counseling a 68-year-old client who is taking doxazosin and denies any history of hypertension, the healthcare provider asks if the client has a history of which other condition?

Benign prostatic hypertrophy

Select the chemical classifications of calcium channel blockers by clicking on the correct answers.

Benzothiazepines Dihydropyridines Phenylalkylamines

The __________ effects of carvedilol are responsible for causing __________ by interfering with receptors in the pancreas.

Beta blocking Hyperglycemia

Match the mechanism of action on the right to the antilipemic drug classification on the left.

Bile acid sequestrants - Bind to bile, which is needed for the absorption of cholesterol from the small intestine, stimulating the liver to absorb more serum cholesterol to synthesize bile acids, which leads to decreased serum low-density lipoprotein (LDL)​. Fibric acid derivatives - Activate lipoprotein lipase, an enzyme responsible for breaking down cholesterol. HMG coenzyme A reductase inhibitors (statins) - Inhibit the enzyme needed to synthesize cholesterol, effectively decreasing serum cholesterol levels.

What is the mechanism of action for angiotensin-converting enzyme (ACE) inhibitors? Select all that apply.

Blocks aldosterone secretion Inhibits vasoconstriction

Select the data that should be collected by the nurse prior to administering metoprolol for chronic heart failure.

Blood pressure Apical pulse

Which antihypertensive medication is contraindicated for an older adult with an esophageal stricture?

Doxazosin

Which medications are included in the adrenergic antihypertensives class? Select all that apply.

Carvedilol Clonidine Methyldopa

A client with newly diagnosed hypertension has an average blood pressure (BP) reading of 158/98 millimeters of mercury (mmHg) after 3 months of exercise and diet modifications. Which management strategy will be a priority for this client?

Drug therapy will be needed because the BP is still not at goal.

Adam (pronouns: he/him/his) has a history of stable angina. Answer each question about Adam's knowledge and experience with angina. Adam's chest pain has not changed after taking the antianginal medication to the maximum dose prescribed. What action should he take next?

Call 911 to request assistance

A client is seen in the emergency department for increased anginal symptoms. In reviewing the client's medication list, which medications, when taken together, increase the client's risk for angina associated with a hypotensive episode? Select all that apply.

Captopril Sildenafil

While administering milrinone to a client with heart failure, which parameter should be monitored closely?

Cardiac rhythm

In administering milrinone by continuous infusion, which condition is a contraindication for this medication?

Cardiac valvular disease

Match each type of angina to the pathophysiologic process that causes it.

Caused by complete blockage of one or more coronary arteries resulting in cell death. - Myocardial infarction Pain that occurs at rest due to narrowing of the coronary arteries. - Unstable angina Results from spasms in the smooth muscle layer of the coronary arteries. - Prinzmetal angina Triggered by stress or exertion increasing myocardial oxygen demand. - Angina pectoris

Many individuals who are aware they have hypertension are not being treated. The nurse understands that which factors can impact how well a client adheres to the prescribed treatment plan? Select all that apply.

Challenges to accessing healthcare Not liking how they feel after trying the medication Cost of medications Not feeling sick

Match the term related to cardiac function to its definition.

Change speed of impulse conduction in the myocardium - Dromotropic drugs Amount of blood in the left ventricle just before each contraction​ - End-diastolic volume Change force of myocardial contractions - Inotropic drugs Change heart rate - Chronotropic drugs Amount of blood ejected from the left ventricle with each contraction​ - Ejection fraction

The nurse includes which parameters in the ongoing focused assessment of clients receiving medications for acute heart failure? Select all that apply.

Check apical pulse Obtain daily weights Monitor serum electrolytes Auscultate lung sounds

__________ is a __________ that binds to and prevents the reabsorption of bile acids from the small intestine.

Cholestyramine Bile acid sequestrant

A nurse is monitoring a client with angina for therapeutic effects of a rapid-acting nitrate given for chest pain. Which assessment finding indicates that the medication has been effective?

Client stating that pain is 0 out of 10.

Which safety consideration is needed for a client who is receiving intravenous milrinone?

Continuous cardiac monitoring

Extracellular calcium is required for the __________ of cardiac and __________ muscle cells.

Contraction Smooth

HMG coenzyme A reductase inhibitors are metabolized by which liver enzyme?​

Cytochrome P-450

Which therapeutic effect is anticipated with the use of an aldosterone inhibitor like spironolactone? Select all that apply.

Decreased fluid retention Increased urine output

When providing care to an older adult taking gemfibrozil, how does the nurse best determine treatment effectiveness?

Decreased triglyceride levels​

Scheduling a __________ nitrate-free period allows plasma and tissue nitrate levels to __________, allowing cells to recover to a responsive state when the next dose is administered. These nitrate-free periods are used to offset __________ that can develop with long-term continuous administration of nitrates.

Daily Fall Tolerance

Which therapeutic effects do heart failure medications have to improve symptoms? Select all that apply.

Decrease myocardial oxygen demand​ Reduce heart rate Reduce edema ​ Increase urine output​

Which factors support the indication for antilipemic medications to be started? Select all that apply.

Elevated low and non-high-density lipoprotein (LDL and non-HDL) levels. Client who has been diagnosed with diabetes. Elevated cardiovascular risk factors as calculated by the healthcare provider​. Advanced client age​

Administration of sacubitril/valsartan is contraindicated for use with individuals whose health history includes which conditions? Select all that apply.

End-stage liver failure Angioedema

Which medication could have a significant drug-to-drug interaction when taken with atorvastatin?

Erythromycin​

A nurse is obtaining subjective assessment data from an older adult client with angina. The client reports that episodes of chest pain have decreased only marginally after three months while taking sublingual nitroglycerin. The nurse asks the client if they are having any difficulty placing the small tablet beneath their tongue. What is the rationale for this question? Select all that apply.

Evaluate the client's understanding of how and when to take the medication. Assess for physical limitations that may affect medication use.

A client reports experiencing an annoying, persistent dry cough that started once they begin taking an angiotensin-converting enzyme (ACE). The client is not experiencing any other signs and symptoms. What is the best response provided by the nurse?

Explain that this is a known, harmless side effect of the medication.

A client taking cholestyramine asks about dietary changes while taking this medication. What does the nurse recommend limiting as part of this cholesterol-lowering therapy? Select all that apply.

Fat Cholesterol

Which antianginal medications are nitrates used to treat episodes of angina? Select all that apply.

Nitroglycerin Isosorbide mononitrate Isosorbide dinitrate

What are the potential side effects of HMG coenzyme A reductase inhibitor use? Select all that apply.

Headache Nausea Blurred vision Insomnia

In addition to angina, for what condition is isosorbide dinitrate indicated?

Heart failure

In addition to hypertension, carvedilol is also prescribed to treat __________ and impaired left ventricular function after a __________.

Heart failure Myocardial infarction (MI)

Which are the correct statements to include as part of the discharge instructions for a client who has chronic heart failure? Select all that apply.

Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias. Clients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine. It is important that clients with heart failure notify their healthcare provider if they gain more than 2-3 pounds in a day or 5 pounds in a week. Heart failure clients should limit sodium intake to 2-3 grams per day.

Which signs and symptoms would demonstrate that a client is experiencing an overdose of beta-blocker medication? Select all that apply.

Heart rate 35 beats per minute Client is very drowsy

A client taking diltiazem to treat an irregular heart rhythm should not take their medication and notify the prescribing healthcare provider if which conditions are present when checking their pulse and blood pressure? Select all that apply.

Heart rate is 32 beats per minute A new rash has developed

What high-priority lifestyle change should the nurse discuss with a client starting antilipemic therapy?

Heart-healthy diet

A client who has been taking antilipemic medication reports abdominal pain and yellowish eyes. What could be an indication of an adverse effect of this medication class?

Hepatic dysfunction​

When atorvastatin is prescribed, what laboratory values should be assessed? Select all that apply.

Hepatic enzymes Cholesterol levels

Hypercholesterolemia is a condition of __________ __________.

High Low-density lipoprotein (LDL)

Hypercholesterolemia indicates the presence of abnormally __________ levels of __________ measured by laboratory testing.

High Low-density lipoproteins

When an angiotensin-converting enzyme (ACE) inhibitor is administered with spironolactone, which is the most likely drug-to-drug interaction?

Hyperkalemia

What priority assessment findings indicate an adverse effect for a client receiving furosemide? Select all that apply.

Hypokalemia​ Decreased blood pressure ​

The nurse is administering antihypertensive drugs to older adult clients. The nurse knows that which adverse effect is of most concern for these clients?

Hypotension

Which action is the first priority of care for a client exhibiting signs and symptoms of angina?

Improve myocardial oxygenation

An individual with diabetes and hypertension is seen in urgent care with severe hypoglycemia. The client is concerned that their usual symptoms of low blood sugar were not present, allowing the blood sugar levels to drop to the point that they become faint. Which of the client's current medications may contribute to the masking of their hypoglycemia?

Labetalol

In addition to hypertension, angiotensin-converting enzyme (ACE) Inhibitors are also prescribed to prevent __________ after a myocardial infarction and decrease the morbidity and mortality associated with __________.

Left ventricular hypertrophy Heart failure

Which teaching point is a priority when the nurse is teaching a client who is taking an angiotensin-converting enzyme (ACE) inhibitor?

Limit foods high in potassium

__________ is a protein synthesized in the liver that contains varying amounts of triglycerides, cholesterol, and phospholipids.​

Lipoprotein

Which angiotensin-converting enzyme (ACE) inhibitor is not metabolized through the liver and is eliminated unchanged in the urine?

Lisinopril

Which are angiotensin-converting enzyme (ACE) inhibitors?

Lisinopril Captopril

What are the goals of antihypertensive therapy? Select all that apply.

Normalization of blood pressure Protect the kidneys Reduce organ damage Prevent stroke

By what routes can diltiazem be administered? Select all that apply.

Oral Intravenous

Metoprolol is available for administration by which routes? Select all that apply.

Oral Intravenous

Angiotensin-converting enzyme (ACE) inhibitors should be used cautiously in individuals with __________ and those with a family history of __________.

Liver disease Angioedema

What are the contraindications of antilipemic therapy with a HMG coenzyme A reductase inhibitor? Select all that apply.

Liver disease Pregnancy

Which medication is used to treat hypertension?

Losartan

An individual taking nifedipine for angina has a new prescription for digoxin. The healthcare provider anticipates that this combination of medications may have what effects? Select all that apply.

Low heart rate Increased digoxin levels Heart failure

HMG coenzyme A reductase inhibitors work to __________ __________ and __________ __________ by blocking a key enzyme.

Lower Low-density lipoproteins (LDL) Raise High-density lipoproteins (HDL)

Select the cells that contain the therapeutic effects of angiotensin converting enzyme (ACE) inhibiting medications.

Lower blood pressure Slow development of heart failure (HF) Improve survival after heart attack Lessen heart failure (HF) symptoms

Use the drop-down menus to fill in the missing pharmacokinetic information of carvedilol.

Medication: Carvedilol Route: Oral Onset: 20-120 minutes Peal: 1-4 hours Half-life: 6-8 hours Duration: 8-24 hours

What are the goals of antianginal therapy? Select all that apply.

Minimize frequency of angina Decrease intensity of anginal pain Prevent myocardial infarction

The angiotensin-converting enzyme (ACE) inhibitor captopril has been shown to reduce the risk of death from which condition?

Myocardial infarction

While reviewing the health history of an individual taking an antihypertensive, the healthcare provider is concerned that which over-the-counter product may interfere with blood pressure medicine? Select all that apply.

Nasal decongestant Nonsteroidal anti-inflammatory drugs (NSAIDs) Appetite suppressant

A client on simvastatin indicates they are planning to get pregnant. Which action is anticipated by the healthcare provider?

New prescription for a bile acid sequestrant.

Although the exact mechanism of action of __________ is unknown, it is believed that it reduces metabolism or catabolism of cholesterol and triglycerides.

Niacin