Hypertension and Its Complications: Chapter 26

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Questions and Answers

What is a primary action of angiotensin-converting enzyme inhibitors (ACE-I)?

Increase blood pressure

Cause hypertension

Reduce proteinuria (correct)

Worsen renal impairment

Which of the following is a nursing consideration for administering ACE inhibitors?

Should be given 1 hour before meals or 2 hours after (correct)

Must be administered with potassium supplements

Can be administered at any time without regard to meals

Must be given only on an empty stomach

What potential adverse effect can ACE inhibitors cause in patients without diabetes?

Increase in insulin sensitivity

Dehydration due to excessive urination

Acute hypotension upon initiation of treatment (correct)

Immediate blood pressure elevation

Which statement accurately reflects the impact of hypertension on health risks?

Hypertension is associated with myocardial infarction and heart failure. Signup and view all the answers

Which ACE inhibitor is specifically noted for causing proteinuria in certain patients?

Enalapril (Vasotec) Signup and view all the answers

What is the primary function of angiotensin II receptor blockers?

Block the conversion of angiotensin I to angiotensin II Signup and view all the answers

Which patient population is often noted to have an ineffective response to angiotensin II receptor blockers?

African American patients Signup and view all the answers

What should be monitored to assess for potential side effects when a patient is on angiotensin II receptor blockers?

Potassium levels for hyperkalemia Signup and view all the answers

Which medication is NOT classified as an angiotensin II receptor blocker?

Lisinopril Signup and view all the answers

Which of the following is a nursing consideration for patients taking angiotensin II receptor blockers?

Monitor renal function for elevating creatinine levels Signup and view all the answers

What effect do calcium channel blockers have on renal flow?

They increase renal flow and enhance excretion. Signup and view all the answers

Which of the following is a common side effect of calcium channel blockers?

Muscle cramps. Signup and view all the answers

Which calcium channel blocker can be used for patients with both hypertension and angina?

Diltiazem. Signup and view all the answers

What is a primary nursing consideration for patients on calcium channel blockers?

Monitor renal and liver function closely. Signup and view all the answers

Which calcium channel blocker is recommended as a first line treatment for African American patients?

Amlodipine. Signup and view all the answers

What mechanism does amlodipine employ to lower blood pressure?

Dilates peripheral arteries and relaxes vascular smooth muscle. Signup and view all the answers

When may Diltiazem be specifically used?

When a patient needs their heart rate and blood pressure controlled. Signup and view all the answers

What is an important consideration when using calcium channel blockers in combination with thiazide diuretics?

They can enhance blood pressure control. Signup and view all the answers

What adverse effect is associated with high doses of calcium channel blockers?

Severe hypotension. Signup and view all the answers

Calcium channel blockers primarily affect which type of muscle?

Smooth muscle. Signup and view all the answers

What is one of the primary uses of Inderal (Propranolol)?

To treat hypertension accompanied with tachycardia Signup and view all the answers

What effect can Inderal have on glycogenolysis?

Slow down glycogenolysis Signup and view all the answers

Which of the following side effects is commonly associated with Inderal?

Wheezing Signup and view all the answers

Inderal should be used with caution in patients with which condition?

Asthma Signup and view all the answers

How does Inderal affect early symptoms of hypoglycemia?

It can mask early symptoms Signup and view all the answers

What effect do higher levels of catecholamines have when using Inderal?

Diminishes cardioselective properties Signup and view all the answers

What is a potential risk when using Inderal with bradycardia?

Exacerbation of heart failure Signup and view all the answers

What is a common treatment purpose for Inderal aside from hypertension?

To treat angina Signup and view all the answers

Inderal can cause which of the following symptoms at elevated doses?

Shortness of breath Signup and view all the answers

What is the primary action of aspirin regarding platelet function?

Suppresses platelet aggregation Signup and view all the answers

What is the primary action of HMG-CoA reductase inhibitors?

Decrease the production of cholesterol Signup and view all the answers

Which consideration is important when administering Simvastatin?

It should be monitored for liver function Signup and view all the answers

Which of the following drugs is classified as an HMG-CoA reductase inhibitor?

Atorvastatin Signup and view all the answers

What adverse effect should be monitored for in patients taking HMG-CoA reductase inhibitors?

Myopathies and muscle pain Signup and view all the answers

Which statement accurately reflects the use of Pravastatin?

Caution should be exercised with concurrent use of grapefruit juice Signup and view all the answers

What is a beneficial effect of HMG-CoA reductase inhibitors for women?

They may provide benefits for women with cardiovascular disease Signup and view all the answers

What therapeutic effect does Digoxin have on the heart?

It exerts positive inotropic effects on contractility Signup and view all the answers

Which of the following is not a purpose of dyslipidemia drugs?

Increase morbidity from cardiovascular disease Signup and view all the answers

Study Notes

Hypertension and Its Risks

Hypertension raises the likelihood of myocardial infarction (MI), heart failure, cerebral infarction and hemorrhage, and renal disease.

Angiotensin-Converting Enzyme Inhibitors (ACE-I)

Captopril (Capoten): Reduces proteinuria; may cause prolonged elevation of creatinine.
Lisinopril (Prinivil): Slows renal impairment progression; should be taken 1 hour before or 2 hours after meals.
Benazepril (Lotensin): Beneficial for diabetes patients; can cause proteinuria.
Enalapril (Vasotec): Effective but may induce proteinuria and acute hypotension.
Fosinopril (Monopril): Requires monitoring for renal function and potassium levels.
Overall action: Decreases vasoconstriction and aldosterone production, promoting vasodilation and reducing sodium and water retention.

Angiotensin II Receptor Blockers (ARBs)

Losartan (Cozaar): Similar effects to ACE-I but lower risk of hyperkalemia and cough.
Candesartan (Atacand) and Irbesartan (Avapro): Monitor for blood pressure and renal function.
Action: Increases renal flow and enhances excretion of electrolytes.

Calcium Channel Blockers (CCBs)

Amlodipine (Norvasc): Widely used, dilates peripheral arteries, first-line for African American patients.
Diltiazem (Cardizem): Controls both heart rate and pressure, useful for angina.
Nifedipine (Procardia) and Verapamil (Calan): Alternative options based on specific patient needs.
Action: Relax vascular smooth muscle, reducing peripheral vascular resistance.

Beta Blockers

Propranolol (Inderal): Acts on beta adrenergic receptors; useful in managing hypertension associated with tachycardia.
Caution: Can mask hypoglycemia symptoms; caution in patients with asthma or bradycardia.

Aspirin's Role

Suppresses platelet aggregation, mitigating thrombus formation without harming endothelial function.

Dyslipidemia Drugs - HMG-CoA Reductase Inhibitors

Atorvastatin (Lipitor) and others: Decrease cholesterol production; significant for heart disease prevention.
Indicated for women with cardiovascular disease; caution against grapefruit juice interaction.
Monitor for myopathies and liver function; be wary of muscle pain as it may indicate rhabdomyolysis.

Cardiac Glycosides

Digoxin (Lanoxin): Enhances cardiac contractility (positive inotropic effect), beneficial in heart failure management.

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Description

Explore the significant impacts of hypertension on health, including its role in myocardial infarction, heart failure, cerebral events, and renal disease. This quiz covers essential nursing considerations and the action of angiotensin-converting enzyme inhibitors. Test your knowledge on how hypertension affects patient outcomes.