Pharm Chp 35 – Flashcards
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A 46-year-old man with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension by his primary care provider after serial blood pressure readings. The clinician has opted to begin the patient on captopril (Capoten). The patient's nurse should recognize that the therapeutic effect of this drug is achieved in what way?
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By inhibiting the transformation of angiotensin I to angiotensin II
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The physician prescribes captopril (Capoten) for your patient and you provide the patient with the appropriate patient education for this drug. What statement by your patient lets you know that your teaching has been effective?
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"I will make sure that I rise slowly from a supine position."
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The client is to start on lisinopril for hypertension. Prior to administration of the medication, the blood pressure is 112/76 mm Hg. What is the nurse's most appropriate action?
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Notify the health care provider.
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The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response?
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"With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease."
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A client is started on trandolapril (Mavik). The client should be instructed that which of the following is a common adverse effect of ACE inhibitor therapy?
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Persistent cough
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You are a clinic nurse who is assessing a new patient prior to their seeing the physician. The patient has a history of hypertension and tells you they are taking benazepril (Lotensin) to control their disease process. A priority nursing assessment in this patient would be to assess them for a history of what?
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Renal disease
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The blood pressure goal for a client with diabetes is? (Choose one)
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130/80 mmHg
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The nurse teaches the client to not stop taking his antihypertensives abruptly because which of the following may occur?
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Rebound hypertension
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A patient is prescribed a potassium-sparing diuretic. What electrolyte imbalance would the patient be prone to develop?
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Hyperkalemia
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A client is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?
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Persistent cough
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The nurse is educating a client with hypertension about dietary changes that help to decrease blood pressure. Which of the following menu selections indicates the need for further client education?
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Ham sandwich with mustard, carrots andcheesy dip
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Most clients with Stage 2 hypertension will require how many antihypertensives to lower blood pressure to goal initially? (Choose one)
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2
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The client has a blood pressure of 165/100 mmHg. The nurse knows that this client would be in classified as which stage of hypertension?
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Stage 2
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A patient taking diltiazem (Cardizem) for hypertension has come to the clinic for a follow-up appointment. What adverse effects would the nurse assess the patient for?
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Peripheral edema and bradycardia
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A patient is experiencing orthostatic hypotension that is due to his antihypertensive therapy. Which nursing diagnosis would be most appropriate?
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Risk for injury
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A patient has been prescribed transdermal clonidine therapy. What potential adverse effects should the nurse warn the patient about?
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Dry mouth and dizziness
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Your 71-year-old male patient has recently been diagnosed with hypertension. Which of the following measurements is a partial indication of effective treatment and management?
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Diastolic blood pressure below 90 mm Hg
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Mr. Emmeott is seen by the physician for follow-up for diabetic nephropathy. The physician prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to?
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Angiotensin II receptor blockers
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A patient has been admitted to a healthcare center for hypertension management. The physician has prescribed a transdermal patch of clonidine. To which area should the nurse apply the transdermal patch?
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Hairless area on the upper arm
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An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for
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falls
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The client taking bisoprolol-hydrochlorothiazide (Ziac) states that he is sure the medication is not decreasing his blood pressure. He tells the nurse he is urinating all the time and he does not like this side effect of the medication.What is the nurse's best response?
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"Bisoprolol-hydrochlorothiazide (Ziac) works by decreasing the workload of your heart and increasing the excretion of fluid."
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A patient is prescribed trandolapril (Mavik). What adverse effect should the patient be instructed on that can occur with angiotensin-converting enzyme inhibitor (ACE inhibitor)?
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Persistent cough
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The goal of therapy for a patient taking antihypertensive medication is what?
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Maintaining the blood pressure within normal limits
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A patient has had multiple blood pressure readings that indicate he is hypertensive. How is hypertension defined?
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Systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg
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The client taking antihypertensive medications is taught to notify the health care provider for which of the following findings?
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Weight gain of five pounds over a 2-day period
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You are caring for a patient who has been diagnosed as having hypertension. You are responsible for teaching the patient about managing the condition with his newly prescribed medication (lisinopril) as well as with nonpharmacologic methods. What statement, made by your patient, suggests that your teaching has been effective?
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"I will make sure that I rise to a standing position slowly."
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Upon review of the lab findings, the nurse identifies the client's potassium level is 5.9 mEq/L. The nurse recognizes that which of the following antihypertensives may be the cause?
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Aliskiren
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Once a client develops primary hypertension, therapy should last for how long? (Choose one)
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Lifelong
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Which of the following to lower blood pressure primarily via suppression of the rennin-angiotensin-aldosterone system? (Choose one)
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Lisinopril (Prinivil)
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A 26-year-old white male patient has been prescribed captopril for hypertension. A nurse has been assigned to the patient to provide education regarding the use of this drug. The nurse will advise the patient that
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a persistent, dry cough may occur; however, it is not serious.
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The client has been started on an ACE inhibitor for hypertension. The client also takes spironolactone (Aldactone) daily. The nurse would evaluate the client for which of the following?
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Hyperkalemia
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You are caring for a 53-year-old patient who is being treated for hypertension. Included in your health teaching for this patient are instructions for the patient to avoid foods high in sodium. What meal choice is best for this patient?
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Grilled chicken, green salad with dressing, and baked apple
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A nurse checks a client's blood pressure and finds it to be 130/82. This client should be classified as having which stage of hypertension?
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Prehypertension
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A nurse is educating a group of nursing students on the adverse effects of antihypertensive drugs. The nurse explains that orthostatic hypotension occurs initially in the therapy. Which of the following pressure changes in an upright position would indicate orthostatic hypotension?
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A fall in the systolic pressure by 10 mm Hg
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A nurse is educating a group of nursing students on the mechanism of actions of angiotensin converting enzyme inhibitors (ACEI). Which of the following should the nurse explain as the hormone produced by the adrenal cortex?
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Aldosterone
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A patient is receiving fosinopril. Which adverse effect would the nurse caution the patient about to help to promote compliance?
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Cough
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Ms. Tacey, a 65-year-old woman, is treated with eplerenone for hypertension. In addition to monitoring blood pressure, what other important assessment needs to be prioritized in her care?
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Potassium levels
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You are caring for a 53-year-old patient being treated for hypertension. One of your responsibilities is teaching the patient about nonpharmacologic methods of managing hypertension. While discussing dietary management, which of the following might you offer as an example of an appropriate meal?
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Grilled chicken, green salad, and iced tea
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A patient is taking a sustained release antihypertensive. You know that the patient teaching about this medication needs to be include what?
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Swallow the drug whole and do not to cut, crush, or chew it
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What drug is a safe and effective calcium channel blocker only if given as sustained-release or extended-release preparations to treat hypertension?
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Diltiazem (Cardizem)
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A clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to
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monitor the patient's blood pressure.
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Which of the following questions would be most important for a nurse to ask a female patient who is starting on an angiotensin II receptor blocker for hypertension?
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"When was your last menstrual period?"
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The client has been prescribed amlodipine (Norvasc) for hypertension. His blood pressure upon a revisit remains elevated. The nurse inquires about the use of which alternative therapy?
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St. John's wort
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A nurse is caring for a patient who has been diagnosed with hypertension and will be taking eplerenone (Inspra). Which of the following would be an appropriate nursing diagnosis for this patient?
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Risk for Injury related to the adverse effect of dizziness
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When a combination of drugs needs to be incorporated into the drug regimen for a hypertensive patient, what type of diuretic is typically used to treat hypertension initially?
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Thiazide
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The client with a history of asthma is ordered propranolol to treat his hypertension. The nurse questions the order because propranolol may cause which of the following?
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Bronchospasm
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A nurse is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the nurse assess before beginning drug therapy?
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Serum potassium levels
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A patient is prescribed losartan (Cozaar). The medication alone is not effective in controlling blood pressure. What medication will increase the effectiveness to control blood pressure in this patient?
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Hydrochlorothiazide (HCTZ)
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A patient with hypertension has been started on losartan, an angiotensin II receptor blocker (ARB). After 6 weeks of therapy, the physician concludes that losartan alone is not adequately controlling the hypertension. What would the physician likely add to the regimen to improve control?
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A diuretic
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Your patient experienced an MI in 2007. He is a 48-year-old man who has frequent episodes of angina. He is tachycardic. What is the first drug of choice for treatment of his condition?
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Beta-blockers
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The client is prescribed prazosin (Minipress) for hypertension. He asks the nurse how the medication works. What is the nurse's best response?
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"It works by making your blood vessels dilate."
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A patient has recently been diagnosed with hypertension. Which of the following outcomes is most important in this patient?
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Multiple diastolic blood pressure readings <90 mm Hg
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The classification of blood pressures published in 2003 offers new "stages" of blood pressures, ranging from normal to Stage 2 hypertension. Your patient, an 80-year-old retired teacher, consistently has blood pressure readings of 146/86 mm Hg. In the 2003 guidelines, what would her blood pressure be designated?
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Isolated systolic hypertension
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After reviewing the various antihypertensive agents, a group of students demonstrate the need for additional teaching when they identify which agent as a calcium channel blocker?
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Valsartan
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The nursing instructor is talking about patients who take an angiotensin II receptor blocker for hypertension. When assessing a female patient who has been given a prescription for an ARB what would the instructor tell the students it would be important for the nurse to ascertain?
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"When was your last menstrual period (LMP)?"
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The squad brought a 48-year-old man to your ED in the midst of a hypertensive emergency. Blood pressure is 188/112 mm Hg, and the patient reports severe headache and drowsiness. He becomes disoriented and vomits. What is your primary goal in this hypertensive emergency?
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Lower blood pressure as quickly as possible
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A 55-year-old man's hypertension has not responded adequately to his current medication regimen consisting of an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions?
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Frequent assessment of the patient's cardiac status
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You are providing an educational class on childhood hypertension at a local town meeting. Included in your information are non-pharmacologic measures to treat hypertension. What is a non-pharmacologic method of treating/managing hypertension? (Mark all that apply.)
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Exercise Diet Weight loss
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A nurse is educating a group of nursing students about the uses of hawthorn, a natural agent used in the treatment of hypertension. Which of the following conditions should the nurse explain as the other indications for hawthorn use? Select all that apply.
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Angina Arrhythmia Heart failure
