NRNP 6566 WEEK1-5 Midterm Exam
Q&A WITH COMPLETE SOLUTIONS
GRADED A+|2025 UPDATE
Hypertensive urgency - CORRECT-ANSWER-severely elevated blood
pressure
180 over 110 or higher without progressive target organ dysfunction
signs and symptoms: severe headache, shortness of breath, epistaxis,
severe anxiety
treatment includes Clonidine (alpha-adrenergic stimulant 0.2 mg initial
dose, then 0.1 mg every hour until controlled or total of 0.8 mg
May experience sedation, possible rebound hypertension once stopped
Captopril - ACE dose of 12.5 to 25mg
Hypertensive emergency - CORRECT-ANSWER-Severely elevated blood
pressure
180 over 120
, can occur with lower blood pressure if impending or progressive target
organ dysfunction ( example : encephalopathy, intracranial
hemorrhage, acute myocardial infarction, pulmonary edema with acute
LV failure, unstable angina, dissecting aortic aneurysm or eclampsia
First intervention - goal is to get blood pressure down to 160-180 or
less than 105 diastolic. First drug choice is nicardipine 2.5 to 1.5 mg
hour intravenously. Side effects include headache, hypotension,
tachycardia, nausea/vomiting, fever, neck pain, indigestion
Second medication is nipride 0.25 to 10 micrograms per kilogram per
minute intravenously. Side effects include brady or tachycardia, nausea,
abdominal pain, twitching, dizziness, headache, flushing, sweating, IV
site irritation. This medication can cause rapid profound hypotension.
Do not give this medication longer than 72 hours as there is a risk for
cyanide poisoning.
Nitroglycerin- 5 to 220 micrograms a minute intravenously. Side effects
include dizziness, headache, hypotension, orthostatics,
numbness/tingling, flushing, nausea/vomiting
Other medications:
Esmolol hydrochloride
Lebetalol - commonly used with pregnant patients
Apresoline- do not give to patients with Coronary artery disease and
aortic dissection. this is a vasodilator, which decreases blood pressure
but increases heart rate and retains fluid
Minoxidil is another vasodilator. good for end stage renal patients
Q&A WITH COMPLETE SOLUTIONS
GRADED A+|2025 UPDATE
Hypertensive urgency - CORRECT-ANSWER-severely elevated blood
pressure
180 over 110 or higher without progressive target organ dysfunction
signs and symptoms: severe headache, shortness of breath, epistaxis,
severe anxiety
treatment includes Clonidine (alpha-adrenergic stimulant 0.2 mg initial
dose, then 0.1 mg every hour until controlled or total of 0.8 mg
May experience sedation, possible rebound hypertension once stopped
Captopril - ACE dose of 12.5 to 25mg
Hypertensive emergency - CORRECT-ANSWER-Severely elevated blood
pressure
180 over 120
, can occur with lower blood pressure if impending or progressive target
organ dysfunction ( example : encephalopathy, intracranial
hemorrhage, acute myocardial infarction, pulmonary edema with acute
LV failure, unstable angina, dissecting aortic aneurysm or eclampsia
First intervention - goal is to get blood pressure down to 160-180 or
less than 105 diastolic. First drug choice is nicardipine 2.5 to 1.5 mg
hour intravenously. Side effects include headache, hypotension,
tachycardia, nausea/vomiting, fever, neck pain, indigestion
Second medication is nipride 0.25 to 10 micrograms per kilogram per
minute intravenously. Side effects include brady or tachycardia, nausea,
abdominal pain, twitching, dizziness, headache, flushing, sweating, IV
site irritation. This medication can cause rapid profound hypotension.
Do not give this medication longer than 72 hours as there is a risk for
cyanide poisoning.
Nitroglycerin- 5 to 220 micrograms a minute intravenously. Side effects
include dizziness, headache, hypotension, orthostatics,
numbness/tingling, flushing, nausea/vomiting
Other medications:
Esmolol hydrochloride
Lebetalol - commonly used with pregnant patients
Apresoline- do not give to patients with Coronary artery disease and
aortic dissection. this is a vasodilator, which decreases blood pressure
but increases heart rate and retains fluid
Minoxidil is another vasodilator. good for end stage renal patients
