HTN meds

The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? "I can take this medication in the morning to reduce nighttime urination." "I will rise slowly when changing from a sitting to a standing position." "My heart rate may slow down with this drug. I will call if my pulse is below 60." "I need to increase my intake of fluids and foods that are high in fiber."

"I will rise slowly when changing from a sitting to a standing position."

An adult male patient is taking medication for blood pressure management. The patient states to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." What is the most appropriate response by the nurse? "It is unfortunate these drugs can cause erectile dysfunction but managing your blood pressure is more important than your sexual performance." "I understand how discouraging it must be to live with this adverse effect, but you could have a stroke if you do not take your blood pressure medications." "Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect." "I am glad you told me about your experience with this common side effect. Sexual performance can be a difficult subject to discuss."

"Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect."

The patient is admitted for the management of a hypertensive emergency. The healthcare provider prescribes sodium nitroprusside [Nipride] drug therapy. What is the priority nursing action during this treatment? Observe for respiratory depression. Monitor the electrocardiogram for tachycardia. Initiate oxygen therapy via nasal cannula at 2 L/min. Adjust the intravenous infusion rate to the blood pressure response.

Adjust the intravenous infusion rate to the blood pressure response.

Clonidine

Alpha2 Agonist

Hydralazine drug interactions

Antihypertensive medications Give with BB to protect againt reflex tachycardia

Clonidine drug interactions

BB Dig MAO-I

Which classes of medications are prescribed as initial therapy for hypertension after a myocardial infarction (MI)? Diuretic and beta blocker Beta blocker and ACE inhibitor ACE inhibitor and calcium channel blocker Diuretic and calcium channel blocker

Beta blocker and ACE inhibitor

Which assessment finding is most important for the nurse to obtain before administering hydralazine [Apresoline]? Peripheral pulses Homans' sign Blood pressure Capillary refill

Blood pressure

Beta blockers drug interactions

CCB Insulin

Clonidine AE

CNS: drowsiness, dizziness, nightmares, anxiety, depression GI: Dry mouth (xerostomia) and constipation CV: bradycardia, decreased CO, rebound hypertension with abrupt withdrawal GU: impotence Caution with older adults: orthostatic hypotension and CNS adverse effects

Why shouldnt pt's abruptly stop taking clonidine?

Can cause rebound hypertension

Beta blockers action

Decrease heart rate, decreased ventricular contractility & cardiac workload Reduced conduction through AV node

Clonidine Contraindications

Diabetes Category C SA node dysfunction Recent MI Coronary insufficiency

Which medication is first line for HTN?

Diltiazem

The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to be prescribed to treat this patient's hypertension? Hydrochlorothiazide [HCTZ] Enalapril [Vasotec] Propranolol [Inderal] Methyldopa [Aldomet]

Enalapril [Vasotec]

Hydralazine uses

Essential hypertension Hypertensive crisis Heart failure

Sodium Nitroprusside AE

Excessive hypotension Cyanide poisoning & thiocyanate toxicity (rare) Consistent monitoring is required

Sodium Nitroprusside

Fastest-acting antihypertensive agent Causes venous and arteriolar dilation IV only, protect from light Immediate onset

Prazosin AE

First dose effect Reflex tachycardia Fluid retention

Beta blockers uses

HTN Angina, MI, heart failure, dysrhythmias, etc.

Prazosin uses

HTN Tx of alpha-1 agonist (Epi) BPH

Clonidine uses

HTN- not first line

Selective dilation of arterioles

Hydralazine

Sodium Nitroprusside uses

Hypertensive emergencies

Beta blockers AE

Hypotension Bradycardia HF Bronchoconstriction Hypoglycemia Rebound cardiac excitation Insomnia, depression

Hydralazine AE

Hypotension Dizziness Reflex tachycardia Fluid retention Systemic lupus erythematosus-like syndrome (painful joints, fever, nephritis) HA, weakness, and fatigue

The nurse is caring for a patient receiving a nitroprusside [Nipride] intravenous infusion. The patient's wife asks why furosemide [Lasix] is being prescribed along with this drug. The nurse's response is based on which concept? Furosemide will help reduce reflex tachycardia. Many vasodilators cause retention of sodium and water. Thiocyanate may accumulate in patients receiving nitroprusside. Vasodilators can cause serious orthostatic hypotension.

Many vasodilators cause retention of sodium and water.

The nurse is caring for a pregnant patient experiencing a new episode of hypertension. Which medication does the nurse anticipate will be prescribed for this patient? Methyldopa [Aldomet] Propranolol [Inderal] Captopril [Capoten] Valsartan [Diovan]

Methyldopa [Aldomet]

Beta blockers nursing implications

Monitor HR, BP, and respirations Hold drug if BP < 90 Systolic and HR < 60 Avoid abrupt discontinuation Causes rebound cardiac excitation

Selective dilation of veins

Nitroglycerin

The nurse reviews the medication treatment regimen for a patient with chronic hypertension. To promote optimal medication adherence, which frequency of drug dosing should the nurse advocate for this patient? Once a day Three times a day Four times a day Every 8 hours

Once a day

Dilate arterioles and veins

Prazosin

Clonidine action

Selective activation of alpha2 receptors in the CNS Reduce the firing of sympathetic neurons in blood vessels and the heart Effects similar to those of the direct-acting adrenergic receptor blockers Lead to vasodilation

Prazosin action

Selective blockade of alpha 1 receptors arterial & venous vasodilation Relaxes smooth muscles in bladder, increased urine flow and decreased residual urine

Hydralazine action

Selective dilation of the arterioles Relaxation of vascular smooth muscle of the arterioles, decreased peripheral resistance, decreased arterial blood pressure Decreased blood pressure, stimulation of the baroreceptor reflex, increased heart rate and myocardial contraction Decreased BP stimulates the RAA system which causes a release of aldosterone

Which laboratory result may be a consequence of therapy with a thiazide diuretic? Serum glucose level of 58 mg/dL Serum potassium level of 5.3 mEq/L Serum sodium level of 135 mEq/L Serum uric acid level of 10.4 mg/dL

Serum uric acid level of 10.4 mg/dL

The nurse is preparing to administer minoxidil [Loniten] 5 mg orally. What is the only cardiovascular indication for this mediacation? Heart failure Myocardial infarction Angina pectoris Severe hypertension

Severe hypertension

A patient with hypertensive emergency is admitted to the hospital. Which medication should the nurse be prepared to administer to this patient? Minoxidil [Loniten] Hydralazine [Apresoline] Sodium nitroprusside [Nipride] Hydralazine and isosorbide dinitrate [BiDil]

Sodium nitroprusside [Nipride]

A patient is admitted to the unit in a hypertensive emergency and examination reveals papilledema. The nurse should expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure? Furosemide [Lasix] Sodium nitroprusside [Nitropress] Metoprolol [Lopressor] Diltiazem [Cardizem]

Sodium nitroprusside [Nitropress]

The nurse is caring for a patient who has been receiving intravenous sodium nitroprusside [Nitropress] for 3 days. Which assessement data indicate the patient may be experiencing thiocyanate toxicity? Sudden confusion Difficulty breathing Erythematous rash Gastrointestinal bleeding

Sudden confusion

The nurse is caring for a patient receiving hydralazine [Apresoline]. The healthcare provider prescribes propranolol [Inderal]. The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose? To reduce the risk of headache To improve hypotensive effects To prevent heart failure To protect against reflex tachycardia

To protect against reflex tachycardia

Clonidine transdermal administration

Transdermal applied every 7 days Applied to hairless upper arm or torso Keep in a place that is easy to find

First dose effect nursing considerations

Warn patients about first dose effect Take first dose at bedtime to eliminate risk of first dose effect Avoid driving or other hazardous activities for first 12-24 hours Rise slowly from lying to sitting and let legs dangle from bed before standing to reduce hypotension Sit or lie down if dizziness, lightheadedness occur