CH 22- Sherpath- WEEK 4

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Questions and Answers

What is the typical timeframe for a medication to achieve its full therapeutic effects?

  • 6 to 8 weeks
  • 1 to 2 weeks
  • 2 to 4 weeks
  • 4 to 6 weeks (correct)

Which of the following is a risk factor for hypertension that must be treated?

  • Diabetes
  • Alzheimer's disease
  • Stroke (correct)
  • Emphysema

What should patients be educated about concerning the dosing of medications?

  • Furosemide should be taken in the evening
  • Bedtime dosing can prevent injury (correct)
  • All medications can be taken at any time
  • Enalapril has to be taken twice daily

Which medication may cause a potential interaction with an ACE inhibitor?

<p>Ibuprofen (A)</p> Signup and view all the answers

What possible effect can occur when combining losartan and ibuprofen?

<p>Decreased effect of losartan (D)</p> Signup and view all the answers

Which of the following medications should be used with caution in patients taking ACE inhibitors?

<p>Spironolactone (D)</p> Signup and view all the answers

Which statement about hypertension and heart-related risks is accurate?

<p>Hypertension increases the risk of cardiovascular disease. (A)</p> Signup and view all the answers

Which medication is indicated for delayed dosing considerations due to its dosing schedule?

<p>Furosemide (C)</p> Signup and view all the answers

What is the main purpose of administering intravenous fluids in cases of minoxidil overdose?

<p>To counteract excessive hypotension (C)</p> Signup and view all the answers

Which sign indicates the therapeutic effectiveness of lisinopril in a heart failure patient?

<p>Clear or improved breath sounds (C)</p> Signup and view all the answers

Which medication is indicated to treat hypertension and improve survival after a myocardial infarction?

<p>Eplerenone (B)</p> Signup and view all the answers

What adverse effect must the nurse monitor for when a patient is on an ACE inhibitor like lisinopril?

<p>Hyperkalemia (A)</p> Signup and view all the answers

Why is monitoring peripheral edema relevant in a patient taking ACE inhibitors?

<p>It shows the effectiveness of decreasing blood volume (A)</p> Signup and view all the answers

Which of the following medications is not indicated for the treatment of hypertension?

<p>Bosentan (D)</p> Signup and view all the answers

What is a common misconception about the therapeutic effects of ACE inhibitors?

<p>They primarily improve mental status. (D)</p> Signup and view all the answers

Which of the following treatments would not directly assist a patient with minoxidil toxicity?

<p>Potassium supplements (A), Antianxiety medications (B), Calcium administration (D)</p> Signup and view all the answers

Which medication belongs to the category of angiotensin II receptor blockers?

<p>Valsartan (B)</p> Signup and view all the answers

What is a primary nursing intervention for a patient taking hydrochlorothiazide?

<p>Encourage intake of foods rich in potassium (C)</p> Signup and view all the answers

After administering an alpha-adrenergic antagonist, which side effect should the nurse specifically monitor for?

<p>Syncope (D)</p> Signup and view all the answers

What important instruction should a nurse give to a patient receiving transdermal clonidine?

<p>Remove the old patch before applying the new patch (A)</p> Signup and view all the answers

Which statement about beta blockers is correct?

<p>They block beta receptors in the heart. (A)</p> Signup and view all the answers

What might occur if adequate potassium is not replaced in a patient on hydrochlorothiazide?

<p>Hypokalemia (D)</p> Signup and view all the answers

Which choice reflects a non-critical monitoring requirement for patients on hydrochlorothiazide?

<p>Checking for symptoms of electrolyte imbalance (A)</p> Signup and view all the answers

What effect might diuresis from hydrochlorothiazide have at night?

<p>Increased nocturia (C)</p> Signup and view all the answers

What is the primary use of sodium nitroprusside in patient care?

<p>Treatment of severe hypertensive emergencies (A)</p> Signup and view all the answers

What action should a nurse take if a patient experiences toxicity from lisinopril?

<p>Prepare the patient for hemodialysis (D)</p> Signup and view all the answers

Which of the following explains how ACE inhibitors treat hypertension?

<p>They reduce the systemic vascular resistance (SVR) (D)</p> Signup and view all the answers

Which action does NOT contribute to the effectiveness of ACE inhibitors in managing hypertension?

<p>They promote increased vascular resistance (B)</p> Signup and view all the answers

What should a nurse prioritize for a patient developing pulmonary edema while on ACE inhibitors and positive inotropes?

<p>Instruct the patient to restrict dietary sodium (B)</p> Signup and view all the answers

Which statement correctly identifies a misconception about angiotensin II?

<p>Angiotensin II has a vasodilatory effect (D)</p> Signup and view all the answers

Which approach is NOT recommended for managing a patient who refuses additional medications for heart failure?

<p>Suggest increasing the dosage of existing medications (B)</p> Signup and view all the answers

What role does systemic vascular resistance (SVR) play in hypertension management with ACE inhibitors?

<p>It regulates the resistance against blood flow from the heart (D)</p> Signup and view all the answers

What should a patient prescribed methyldopa during pregnancy be taught regarding rising from a seated position?

<p>Sit on the side of the bed before getting up, and get up slowly. (A)</p> Signup and view all the answers

Which patient receiving losartan requires closer monitoring due to possible renal issues?

<p>A patient with an elevated creatinine level. (D)</p> Signup and view all the answers

What should a nurse do for a patient with asthma who is prescribed carvedilol?

<p>Notify the health care provider about the patient's asthma. (C)</p> Signup and view all the answers

Which statement about the administration of methyldopa is correct?

<p>Timing of the dosage is not restricted to the morning. (C)</p> Signup and view all the answers

What potential side effect should be monitored in patients taking losartan?

<p>Renal dysfunction. (C)</p> Signup and view all the answers

Which of the following medications can lead to hyperkalemia?

<p>Losartan. (C)</p> Signup and view all the answers

What is a contraindication for the use of carvedilol?

<p>History of asthma. (D)</p> Signup and view all the answers

Why would a health care provider need to be notified when a patient with asthma is prescribed carvedilol?

<p>Beta blockers can trigger bronchoconstriction. (D)</p> Signup and view all the answers

What should a nurse do for a patient with liver disease who is prescribed bosentan?

<p>Notify the health care provider (C)</p> Signup and view all the answers

If a patient is NPO but takes lisinopril daily, what is the correct nursing action?

<p>Obtain a prescription for intravenous enalapril (C)</p> Signup and view all the answers

What is the priority nursing action for a patient experiencing toxic levels of sodium nitroprusside?

<p>Stop the infusion of the drug (D)</p> Signup and view all the answers

What is a significant risk of abruptly stopping bosentan in a patient with liver disease?

<p>Development of hypertensive crisis (D)</p> Signup and view all the answers

Why is enalapril preferred for patients requiring parenteral ACE inhibitors?

<p>It is the only available ACE inhibitor in parenteral form (A)</p> Signup and view all the answers

What is the immediate effect when sodium nitroprusside infusion is stopped?

<p>Rapid increase in blood pressure (B)</p> Signup and view all the answers

Which of the following nursing actions is unnecessary if a patient is on a strict NPO order and taking oral medications?

<p>Administering medications without water (B)</p> Signup and view all the answers

In what scenario is it acceptable to maintain a patient on bosentan despite liver impairment?

<p>It is never acceptable (B)</p> Signup and view all the answers

Flashcards

Angiotensin II receptor blockers (ARBs)

Medications that block the action of angiotensin II, a hormone that narrows blood vessels.

ACE inhibitors

Medications that prevent the conversion of angiotensin I to angiotensin II.

Beta blockers

Medications that block beta receptors in the heart, decreasing heart rate and blood pressure.

Loop diuretics

Drugs that increase urine output by inhibiting sodium and chloride reabsorption in the loop of Henle.

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Hydrochlorothiazide side effect

Can cause potassium loss (hypokalemia).

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First-dose syncope

Sudden fainting after taking the first dose of an alpha-adrenergic antagonist.

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Transdermal clonidine application

Remove the old patch before applying a new one.

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Appropriate Hydrochlorothiazide Administration

Take in the morning to reduce nighttime urination.

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Delayed medication onset

Some medications take several weeks to reach their full effect.

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Hypertension risk factors

Hypertension raises risk for stroke, heart failure, and cardiovascular disease.

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ACE inhibitor interactions

Certain medications, like potassium supplements and potassium-sparing diuretics, can interact with ACE inhibitors.

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ACE inhibitor & NSAID interaction

Combining ACE inhibitors with NSAIDs may lead to kidney problems.

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Losartan and ibuprofen interaction

Taking losartan (ARB) with ibuprofen (NSAID) can decrease losartan's blood pressure-lowering effect and increase the risk of kidney problems.

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Medication education

Educating patients about delayed onset of medication action and proper dosing is crucial.

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Furosemide dosage time

Furosemide (diuretic) should be taken in the morning.

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ACE inhibitors and anticoagulants

There's no known interaction between ACE inhibitors and anticoagulants like warfarin.

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Minoxidil overdose treatment

Intravenous fluids are used to counteract the hypotension caused by excessive vasodilation.

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Lisinopril effectiveness in heart failure

Improved breath sounds indicate successful lowering of blood volume and pressure, a result of ACE inhibitor action.

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Hypertension post-MI treatment

Eplerenone is used to treat hypertension and improve survival after a heart attack.

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Minoxidil toxicity

Minoxidil toxicity causes excessive vasodilation and hypotension.

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ACE Inhibitor effect on breath sounds

Improved breath sounds in heart failure demonstrate the effectiveness of ACE Inhibitors.

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Lisinopril and mental status

Mental status is not a reliable indicator of Lisinopril effectiveness in heart failure

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Bosentan indication

Bosentan is primarily used for pulmonary artery hypertension in moderate to severe heart failure

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Treprostinil indication

Treprostinil is a treatment for pulmonary artery hypertension in moderate to severe heart failure.

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Methyldopa in Pregnancy

Medication for pregnancy-related hypertension; caution advised regarding orthostatic hypotension.

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Losartan Monitoring

Patients with kidney issues (elevated creatinine) need close monitoring when taking losartan.

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Carvedilol & Asthma

Carvedilol is contraindicated for patients with a history of asthma.

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Orthostatic Hypotension

Sudden drop in blood pressure when standing up, often associated with certain medications.

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Elevated Creatinine

High creatinine levels indicate potential kidney problems.

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Hyperkalemia Risk

Some medications can raise potassium levels; monitor closely if potassium already low.

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Medication Contraindication

A specific condition that prevents the use of a certain medication.

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Medication for Pregnancy Hypertension

A drug taken to treat high blood pressure during pregnancy.

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Sodium Nitroprusside Use

Intravenous medication for severe hypertension emergencies, titrated as needed.

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Lisinopril Toxicity Treatment

Hemodialysis is used to remove the drug from the bloodstream in cases of toxicity or overdose.

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ACE Inhibitors & Hypertension

ACE inhibitors reduce afterload (resistance to blood flow output) and systemic vascular resistance (SVR), preventing angiotensin II's vasoconstriction effects.

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Angiotensin II Role

A potent vasoconstrictor, it also stimulates aldosterone release, promoting sodium and water retention.

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Pulmonary Edema Treatment - No New Meds

Collaborate with the provider to find a combination ACE inhibitor and diuretic if additional medications are unwanted.

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ACE Inhibitors & Sodium Retention

ACE inhibitors block the conversion of angiotensin I to angiotensin II, reducing aldosterone secretion (and resulting sodium/water retention).

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Systemic Vascular Resistance

Resistance to blood flow determined by blood vessel diameter and vascular musculature.

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Pulmonary Edema

Fluid buildup in the lungs, a potential complication of certain medications for heart failure.

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Bosentan & Liver Disease

Patients with impaired liver function should not take Bosentan.

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Lisinopril & NPO

If a patient is NPO (nothing by mouth), a parenteral ACE inhibitor (like enalapril) is needed.

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Sodium Nitroprusside Toxicity

Excessive hypotension during sodium nitroprusside infusion indicates a toxic level.

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Priority Action for Nitroprusside Toxicity

Stopping the drug infusion.

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Asthma Exacerbation & Medication

Asthma exacerbation is an adverse effect of medication, not a toxic level.

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Nurses Role in NPO Patient

Collaborate with provider to assess if intravenous medication is needed.

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Nurses Role in Liver Disease

Notify the healthcare provider about the patient's liver disease.

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Priority Action for Drug Toxicity

Discontinue the drug immediately when there's evidence of toxicity.

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Related Documents

EAQ 8.pdf

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