NURA 221 EXAM 3 STUDY SET
regular blood pressure
less than 120/80
elevated BP
Systolic between 120-129 and diastolic less than 80
Stage 1 HTN
130-139/80-89
Stage 2 HTN
>140 or >90
hypertensive crisis
systolic over 180 and/or diastolic over 120
S/S of HTN crisis
headache or any change in headache
vision issues (double, loss, decrease, colour change)
N/V
immediate ER visit
How do we treat pts in an HTN crisis with no symptoms
adjust meds
orthostatic hypotension
low blood pressure that occurs upon standing up
drop in BP less than 20mmHg sys or 10mmHg dia with postural change within 2
minutes.
,the adjustment period for anti-HTN meds?
1-3 months
most common long-term issues of HTN
AMI and CVA
What should you do before administering an antihypertensive medication?
•Take BP before administration
•Hold and call the provider if SBP < 90 mmHg
•Consider immediate help if SBP < 70 mmHg
Why is hypertension called the silent killer?
Because it often has no symptoms
HTN risk factors
•Smoking
•DM
•Diet
•> 60 years of age
•Gender (males and post-menopausal females)-Consider trans population
•Obesity
•Race (African American greatest risk)
two categories of HTN
primary and secondary
primary HTN
•(idiopathic or essential)
•Unknown cause
,•Accounts for ~90% of all HTN cases
secondary HTN
•~10% of all cases
•Underlying cause: pheochromocytoma, toxemia, renal disease, etc.
How do ACE inhibitors work?
prevent the conversion of angiotensin I to angiotensin II which prevents
vasoconstriction
ACE inhibitor
first line of treatment for HTN
list of ACE inhibitors
•captopril (Capoten)
•enalapril (Vasotec)
•enalaprilat (Vasotec IV)
•lisinopril (Prinivil, Zestril)
•ramipril (Altace)
•Benazepril (Lotensin)
•fosinopril (Monopril)
•moexipril (Univasc)
•perindopril (Aceon)
•trandolapril (Mavik)
known as the prils
clinical uses for ACE inhibitors
hypertension
heart failure
, myocardial infarction
insulin resistance
Why are ACE inhibitors good for diabetics?
Make insulin receptors more sensitive, enhancing binding of insulin.
SE/AR of ACE inhibitors
•Renal insufficiency
•Hyperkalemia
•Hypotension
•Dry cough
•Rash
•Angioedema
Why shouldn't you use ACE inhibitors in pts with renal insufficiency?
Lower aldosterone secretion = increased retention of K+ by kidneys
Most common side effect of ACE inhibitors?
Dry cough
What is the number 1 medication class that causes angioedema?
ACE inhibitors, must stop med
angioedema
Localized areas of swelling beneath the skin, often around the eyes and lips, but it
can also involve other body areas as well.
Nursing considerations for ACE inhibitors
regular blood pressure
less than 120/80
elevated BP
Systolic between 120-129 and diastolic less than 80
Stage 1 HTN
130-139/80-89
Stage 2 HTN
>140 or >90
hypertensive crisis
systolic over 180 and/or diastolic over 120
S/S of HTN crisis
headache or any change in headache
vision issues (double, loss, decrease, colour change)
N/V
immediate ER visit
How do we treat pts in an HTN crisis with no symptoms
adjust meds
orthostatic hypotension
low blood pressure that occurs upon standing up
drop in BP less than 20mmHg sys or 10mmHg dia with postural change within 2
minutes.
,the adjustment period for anti-HTN meds?
1-3 months
most common long-term issues of HTN
AMI and CVA
What should you do before administering an antihypertensive medication?
•Take BP before administration
•Hold and call the provider if SBP < 90 mmHg
•Consider immediate help if SBP < 70 mmHg
Why is hypertension called the silent killer?
Because it often has no symptoms
HTN risk factors
•Smoking
•DM
•Diet
•> 60 years of age
•Gender (males and post-menopausal females)-Consider trans population
•Obesity
•Race (African American greatest risk)
two categories of HTN
primary and secondary
primary HTN
•(idiopathic or essential)
•Unknown cause
,•Accounts for ~90% of all HTN cases
secondary HTN
•~10% of all cases
•Underlying cause: pheochromocytoma, toxemia, renal disease, etc.
How do ACE inhibitors work?
prevent the conversion of angiotensin I to angiotensin II which prevents
vasoconstriction
ACE inhibitor
first line of treatment for HTN
list of ACE inhibitors
•captopril (Capoten)
•enalapril (Vasotec)
•enalaprilat (Vasotec IV)
•lisinopril (Prinivil, Zestril)
•ramipril (Altace)
•Benazepril (Lotensin)
•fosinopril (Monopril)
•moexipril (Univasc)
•perindopril (Aceon)
•trandolapril (Mavik)
known as the prils
clinical uses for ACE inhibitors
hypertension
heart failure
, myocardial infarction
insulin resistance
Why are ACE inhibitors good for diabetics?
Make insulin receptors more sensitive, enhancing binding of insulin.
SE/AR of ACE inhibitors
•Renal insufficiency
•Hyperkalemia
•Hypotension
•Dry cough
•Rash
•Angioedema
Why shouldn't you use ACE inhibitors in pts with renal insufficiency?
Lower aldosterone secretion = increased retention of K+ by kidneys
Most common side effect of ACE inhibitors?
Dry cough
What is the number 1 medication class that causes angioedema?
ACE inhibitors, must stop med
angioedema
Localized areas of swelling beneath the skin, often around the eyes and lips, but it
can also involve other body areas as well.
Nursing considerations for ACE inhibitors
