(1) Baroreceptors in the aortic arch and carotid sinus sense BP and relay this information to the brainstem. (2) When BP is perceived as too low, the brainstem sends impulses along sympathetic nerves to stimulate the heart and blood vessels. (3) BP is then elevated by (a) activation of beta 1 receptors in the heart resulting in increased cardiac output and (b) activation of vascular alpha 1 receptors resulting in vasoconstriction. (4) When BP has been restored to an acceptable level, sympathetic stimulation of the heart and vascular smooth muscle subsides. Show List the sympathetic baroreceptor reflex and blood pressure (BP) steps in order Which class(es) of medications are prescribed as initial therapy for hypertension after myocardial infarction (MI)? Select all that apply. Diuretic Beta blocker- Aldosterone antagonists- Calcium channel blocker Angiotensin-converting enzyme (ACE) inhibitor- Beta blockers and ACE inhibitors, as well as aldosterone antagonists, are the drug classes recommended for initial therapy of hypertension after MI. Diuretics and calcium channel blockers are not part of initial therapy for hypertension after MI. The nurse is caring for several patients. Which patient will need teaching about treatment of hypertension? The patient with a diastolic pressure of 70 mm Hg and above The patient with a systolic pressure consistently above 140 mm Hg- The patient with a diastolic blood pressure 80 mm Hg after exercise The patient with a blood pressure of 140/90 mm Hg after walking up two flights of stairs Hypertension is defined as a persistent systolic pressure of greater than 140 mm Hg and or a diastolic pressure greater than 90 mm Hg. A patient is not diagnosed with hypertension after one episode of an elevated pressure. Which statement made to the patient will demonstrate the nurse's knowledge of calcium-channel blockers (CCBs) for management of hypertension? "CCBs promote excretion of water." "CCBs block reabsorption of sodium." "CCBs increase blood return to heart." "CCBs relax vascular smooth muscle."- By blocking calcium channels, CCBs inhibit muscle contraction in the coronary arteries and peripheral arteries resulting in vasodilation, improved blood flow to the myocardium, and decreased blood pressure. CCBs have no direct role in sodium or water activity. Since CCBs decrease blood return to the heart, preload is reduced. Which comment by the patient indicates understanding about the use of enalapril for treatment of hypertension? "I cannot go out in the sun while on this therapy." "I should stop the drug if I have ringing in my ears." "If I feel tired, I should call the health care provider." "If I develop a chronic cough, I need to notify my health care provider."- The patient on therapy with an angiotensin-converting enzyme inhibitor such as enalapril needs to report a nonproductive chronic cough because this is a potential side effect. There is no treatment other than to change the medication therapy. Enalapril does not cause sun sensitivity, tinnitus, or fatigue. The patient taking an alpha 1 blocker. Of which potentially dangerous side effect should the patient be made aware? Increased heart rate Orthostatic hypotension- Increased urinary output Increased urinary flow rate An alpha 1 blocker can cause the dangerous side effect of orthostatic hypotension. It should also increase urinary flow rates and increase urinary output, but these are not disturbing side effects; they are demonstrating the therapeutic effect of this medication. This medication should not increase heart rate. Which statement will be included in the teaching about calcium channel blockers? "This medication will help you to get rid of sodium." "This medication will work to cause you to get rid of fluid." "This medication will help you to lose weight to lower your blood pressure." "This medication will enable vasodilation of your blood vessels to lower your blood pressure."- This medication causes vasodilation and is used in hypertension to lower blood pressure. It causes direct vasodilation by blocking calcium influx in smooth muscles in the blood vessels. This medication class does not help to rid fluids, decrease sodium, or help the patient to lose weight. Which medication will decrease vasoconstriction by blocking angiotensin II receptor sites? Valsartan Enalapril Furosemide Metoprolol The category of medications that block angiotensin II receptor sites are medications ending in "sartan." Valsartan [Diovan] is in this category. Medications ending in "lol" are beta blockers. Medications ending in "pril" are angiotensin-converting enzyme inhibitors. Furosemide is a loop diuretic. A nurse is reviewing the medication records and finds the patient is receiving a direct renin inhibitor. Which drug will the nurse administer? Aliskiren- Nifedipine Eplerenone Candesartan There is only one direct renin inhibitor available: aliskiren. Nifedipine is a calcium channel blocker. Eplerenone is an aldosterone antagonist. Candesartan is an angiotensin II receptor blocker. The nurse is caring for a patient who is scheduled to begin treatment with carvedilol. While updating the history, the patient tells the nurse that he experiences frequent attacks of asthma. What is the nurse's highest priority action? Expect a decreased effect from the medication. Expect an increased effect from the medication. Notify the health care provider of this information.- Monitor the patient for a toxic reaction to the drug. Carvedilol should be used with caution in patients with a history of asthma. The priority for the nurse is to notify the health care provider of this information. The provider is likely to use a different medication. The effects will not be increased or decreased because of the patient's asthma. Toxicity is not associated with carvedilol. A nurse is caring for an afebrile patient who is taking an angiotensin-converting enzyme (ACE) inhibitor and develops a dry, nonproductive cough. What is the nurse's priority action? Notify the health care provider.- Tell the patient that the cough will subside in a few days. Assess the patient for other symptoms of upper respiratory infection. Instruct the patient to take antitussive medication until the symptoms subside. ACE inhibitors prevent the breakdown of bradykinin, frequently causing a nonproductive cough. Angiotensin-receptor blocking agents do not block this breakdown, thus minimizing this annoying side effect. The health care provider should switch the patient to a different medication if the side effect cannot be tolerated. The nurse would not instruct the patient to take antitussive medications because the cough is a side effect of the ACE inhibitor. The patient is afebrile and there is a reason for the cough, so it is not necessary to assess the patient for additional signs of infection. The nurse is instructing a patient about potential adverse effects of a prescribed angiotensin-converting enzyme inhibitor. The nurse would instruct the patient to immediately seek medical attention if which adverse effect occurs? Fatigue Diarrhea Angioedema- Dry, nonproductive cough Angioedema is a strong vascular reaction involving inflammation of submucosal tissue (eg, laryngeal edema) and can result in anaphylaxis. Fatigue and a dry, nonproductive cough are adverse reactions but are not life-threatening. Diarrhea is not an adverse effect. Which goal does the nurse document in the plan of care for a 63-year-old patient with hypertension? Maintain blood pressure below 140/70 mm Hg Maintain blood pressure below 140/90 mm Hg Maintain blood pressure below 140/50 mm Hg Maintain blood pressure below 150/90 mm Hg- For patients 60 years of age and older, the goal is to maintain systolic blood pressure (SBP) below 150 mm Hg and diastolic blood pressure (DBP) below 90 mm Hg. For patients younger than 60 years of age, the goal is to maintain SBP below 140 mm Hg and DBP below 90 mm Hg. A diastolic of 70 or lower is too low. When teaching a patient about the drug clonidine, what information will the nurse include in the teaching plan? Do not stop the medication abruptly."- "Stop the medication if you feel tired." "If you have gastric upset, take the medication with an antacid." "Use a hot tub daily to help vasodilation so that the medication will work more effectively." The medication cannot be stopped abruptly because this can cause rebound hypertension. The medication should not be taken with an antacid, which this may delay absorption. The patient is typically tired at the beginning of therapy and should not stop the medication. Using a hot tub or staying in hot water for long periods is not recommended. A patient has a prescription for hypertension that blocks both alpha and beta receptors. Which drug will the nurse administer? Reserpine Carvedilol- Methyldopa Propranolol Carvedilol is unusual in that it can block alpha 1 receptors as well as beta receptors. Reserpine is an adrenergic neuron blocker. Methyldopa is a centrally acting alpha 2 agonist. Propranolol is a beta-adrenergic blocker. The community health nurse is providing education on an antihypertensive medication, clonidine, to an elderly patient during a home visit. The nurse stresses that the patient should not abruptly discontinue the medication because of which potential effect? Dry mouth Hypotension Restlessness Rebound hypertension- If treatment of clonidine is abruptly discontinued, there is a risk of severe rebound hypertension. Dry mouth and hypotension are potential adverse effects of using this medication but are not known to occur when the medication is discontinued. Sedation, not restlessness, is a side effect of using clonidine. What is a priority nursing diagnosis for a patient taking an antihypertensive medication? Fatigue related to side effects of medication Knowledge deficit related to medication regimen Alteration in comfort related to nonproductive cough Alteration in cardiac output related to effects on Following the priorities of airway and breathing and circulation, an alteration in cardiac output is the higher priority over fatigue, pain, and knowledge deficit. Which statement indicates to the nurse that the patient needs additional instruction about antihypertensive treatment? I will change my position slowly to prevent feeling dizzy." "I will not mow my lawn until I see how this medication makes me feel." "I will check my blood pressure daily and take my medication when it is over 140/90."- "I will include rest periods during the day to help me tolerate the fatigue my medicine may cause." Antihypertensive medications need to be taken routinely to maintain a normotensive state and prevent occurrence of complications. Many patients do not adhere to this regimen because hypertension itself does not cause symptoms, whereas the medication can cause some untoward effects. Patient teaching is essential. If the patient indicates that he will take rest periods and change positions slowly to avoid orthostatic hypotension, he is demonstrating adherence to the treatment regimen. A patient with hypertension will be started on a diuretic as first-line drug therapy after lifestyle changes have been ineffective. Which type of diuretics does the nurse anticipate will be used? A loop diuretic A thiazide diuretic- An osmotic diuretic A potassium-sparing diuretic The thiazide diuretics such as hydrochlorothiazide are the most commonly used diuretics for the treatment of hypertension. Loop, osmotic, and potassium-sparing diuretics are not drugs of first choice for uncomplicated hypertension. When monitoring patients receiving antihypertensive agents, the nurse realizes which medication could have a side effect similar to those of systemic lupus erythematosus? Lisinopril Valsartan Aliskiren Hydralazine- Hydralazine can cause a syndrome resembling systemic lupus erythematosus. This reaction is rare. If the reaction occurs, the medication must be withdrawn. This medication is a third-line drug for therapy. The charge nurse is teaching a student nurse about antihypertensive drugs and the renin-angiotensin-aldosterone system. Which statement from the student nurse indicates a correct understanding of the teaching? "Aldosterone antagonists decrease release of renin." "Direct renin inhibitors stop the changing of angiotensinogen into angiotensin I."- "Angiotensin II receptor blockers block the formation of angiotensin II." We can prevent conversion of angiotensinogen to angiotensin I with a direct renin inhibitor. We can block receptors for angiotensin II with an angiotensin II receptor blocker. We can block receptors for aldosterone with an aldosterone antagonist. We can prevent the conversion of angiotensin I into angiotensin II with an angiotensin-converting enzyme inhibitor. A calcium channel blocker has been ordered for a patient. Which condition in the patient's history is contraindicated with this medication? Hypotension- Hypokalemia Dysrhythmias Increased intracranial pressure Calcium channel blockers cause vasodilation with the resulting drop in blood pressure. They are contraindicated in the presence of hypotension. Hypokalemia, dysrhythmias, and increased intracranial pressure are not contraindications for the use of this group of medications. A nurse is preparing to administer eplerenone to a patient with hypertension. Which action is priority? Checking pulse Checking temperature Checking calcium serum level Checking potassium serum level- Checking potassium serum level is the priority. Eplerenone promotes renal retention of potassium, and hence poses a risk of hyperkalemia. Accordingly, it should not be given to patients with existing hyperkalemia. It does not affect calcium levels, temperature, or pulse. Beta blockers affect pulse. A patient receiving the adrenergic medication clonidine reports experiencing dry mouth. What will be included in the plan of care for this patient? Restrict dietary fiber intake. Limit fluids to 1000 mL/day. Inform the patient that these are common adverse effects of the medication.- Discuss incorporation of psyllium-based products in the plan of care with the health care provider. Dry mouth is one of the most common adverse effects of adrenergic medications such as clonidine, so the patient should be made aware of this. Restricting dietary fiber intake, limiting fluids, and incorporating a psyllium-based product in the patient's diet will not help with the complaint of dry mouth. The nurse administers clonidine. Which finding indicates the medication is therapeutic? There is increased urinary output. There is an absence of chest pain. The heart rate decreases from 100 beats/min to 40 beats/min. Blood pressure decreases from 150/100 mm Hg to 110/70 mm Hg.- Clonidine is used primarily for its ability to decrease blood pressure. It is not used for angina or to decrease the heart rate. It is not a diuretic and will not increase urinary output. Which medication does the nurse anticipate to be prescribed to a pregnant patient who developed hypertension at 28 weeks estimated gestational age? Captopril Valsartan Methyldopa- Propranolol Hypertension is the most common complication of pregnancy, occurring in about 10% of pregnant patients. When drug therapy is initiated during pregnancy, methyldopa is the traditional agent of choice because of its limited effects on the fetus. Patients with preexisting hypertension typically can continue taking the antihypertensives they previously were prescribed, except for angiotensin-converting enzyme inhibitors, such as captopril; angiotensin II receptor blockers, such as valsartan; and direct renin inhibitors, such as aliskiren. The nurse is teaching the patient why hypertension must be treated. Which complications would be included in the teaching plan? Select all that apply. Stroke Diabetes Heart failure Emphysema Cardiovascular disease Hypertension is a risk factor for cardiovascular disease, stroke, and heart failure. It is not a risk factor for emphysema or diabetes. The nurse is reviewing a medication history on a patient taking an angiotensin-converting enzyme (ACE) inhibitor. The nurse will contact the health care provider if the patient is also taking which medication? Furosemide Spironolactone- Morphine sulfate Docusate sodium ACE inhibitors block the conversion of angiotensin I to angiotensin II, thus also blocking the stimulus for aldosterone production. Aldosterone is responsible for potassium excretion—decreased aldosterone can result in increased serum potassium levels. Spironolactone is a potassium-sparing diuretic and should not be administered with an ACE inhibitor. The other medications do not cause side effects with this medication. A middle-aged male patient who recently started antihypertensive drug therapy informs the nurse that he has had some problems with erectile dysfunction. Which would be the most appropriate response by the nurse? "Don't worry. Eventually, tolerance will develop." "The physician can work with you on changing the dose and/or medications." "Sexual dysfunction happens with this therapy, and you will learn to accept it." "This is an unusual occurrence, but it is important to stay on your medications." Beta blockers and adrenergic medications used in the treatment of hypertension can result in the common adverse effect of erectile dysfunction in males. Consideration should be given to switching to an alternative medication for blood pressure control. The patient's complaint should not be dismissed, and factual information should be provided. Which laboratory result may be a consequence of therapy with a thiazide diuretic? Serum glucose level of 58 mg/dL Serum sodium level of 135 mEq/L Serum uric acid level of 10.4 mg/dL- Serum potassium level of 5.3 mEq/L Hyperuricemia is a side effect of thiazide diuretics. Normal uric acid levels typically range from 3.6 to 8.5 mg/dL. Hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia, are side effects of thiazides. A serum sodium of 135 mEq/L is a normal value. The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to be prescribed to treat this patient's hypertension? Enalapril- Methyldopa Propranolol Hydrochlorothiazide Preferred antihypertensives for patients with diabetes include angiotensin-converting enzyme (ACE) inhibitors, such as enalapril; angiotensin receptor blockers; and calcium channel blockers. ACE inhibitors are particularly useful, because they slow the progression of diabetic nephropathy in addition to lowering blood pressure. Thiazide diuretics promote hyperglycemia and are used with caution. A nurse is teaching a patient with advanced renal insufficiency about hypertensive drugs. Which statement, if made by the patient, indicates effective understanding of the information? "All diuretics are good for me." "Loop diuretics are good for me."- "Thiazide diuretics are good for me." "Potassium-sparing diuretics are good for me." In patients with advanced renal insufficiency, thiazide diuretics are ineffective; hence, a loop diuretic should be employed. Potassium-sparing diuretics should be avoided. Therefore, all diuretics are not good. A patient is admitted in a hypertensive emergency, and examination reveals papilledema. The nurse would anticipate administering which medication? Diltiazem Metoprolol Furosemide Sodium nitroprusside- Hypertensive emergency associated with papilledema, intracranial hemorrhage, myocardial infarction, or acute heart failure is a severe emergency, and the blood pressure must be lowered rapidly (within 1 hour). Intravenous (IV) sodium nitroprusside usually is the drug of choice first used, because its effects begin within seconds of initiation of the continuous IV infusion, and they fade rapidly when the infusion is stopped. Furosemide, metoprolol, and diltiazem are not used for rapid reduction of blood pressure in hypertensive crisis. The nurse is providing teaching to an elderly male patient who has been prescribed extended-release doxazosin. Which statements would the nurse include? Select all that apply. This medication carries some cardiovascular risk."- "A glass of wine a few times a week should not be a problem." "The medication is contraindicated if you develop benign prostatic hypertrophy (BPH)." "You may develop a nonproductive, dry cough from this medication."- "Be especially careful when changing positions after your first dose of the medication."- Doxazosin is a commonly used alpha 1 blocker that is available in immediate and extended-release formulations. This drug causes some cardiovascular risk and thus is not the preferred therapy. The patient should be informed that this will happen and should be reassured that the active drug has been absorbed. With doxazosin, first-dose orthostatic hypotension may occur within 2 to 6 hours; therefore, patients should be instructed to change positions slowly. Central nervous system (CNS) depressants such as alcohol should be avoided to prevent additional CNS depression. A dry, nonproductive cough is an adverse effect of angiotensin-converting enzyme inhibitors. Doxazosin is useful in treatment of obstructive BPH. A patient is receiving transdermal clonidine. What information does the nurse need to include in the teaching plan? Do not abruptly discontinue the medication." "Take the medication on an empty stomach." "Stay in bed for at least 1 hour when receiving a new patch." "Keep the new patch on for 30 minutes before removing the old patch." Abrupt discontinuation of clonidine can cause rebound hypertension. The medication is not an oral medication, so it can be taken without respect to food. It is unnecessary to stay in bed for at least an hour after a new patch is applied. The patient should remove the old patch and replace it at the same time. The health care provider prescribes a sodium nitroprusside intravenous infusion to manage a patient's blood pressure of 230/120 mm Hg. Which action(s) does the nurse implement before starting the infusion? Select all that apply. Evaluate the electrocardiogram. Perform a neurologic assessment.- Monitor blood pressure continuously.- Obtain an intravenous infusion pump.- Draw baseline serum electrolyte levels. Assess the patient for peripheral edema. The medication should only be infused via an intravenous pump and not by gravity drip. Cyanide/thiocyanate toxicity from sodium nitroprusside infusion can lead to mental status changes, so a baseline neurologic examination is crucial to determine if the patient is experiencing an adverse effect. The patient's blood pressure must be monitored continuously to ensure hypotension does not occur and the drug is titrated appropriately. Although obtaining baseline electrolyte levels is a reasonable nursing action in a patient who is in crisis, laboratory tests related to nitroprusside administration include platelet count, renal function testing, and hematologic assessments. This medication is unlikely to cause edema. An adult male patient who takes a beta blocker medication for blood pressure management states to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." What is the most appropriate response by the nurse? "I am glad you told me about your experience with this common side effect. Sexual performance can be a difficult subject to discuss." "It is unfortunate these drugs can cause erectile dysfunction, but managing your blood pressure is more important than your sexual performance." "I understand how discouraging it must be to live with this adverse effect, but you could have a stroke if you do not take your blood pressure medications." "Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect."- Many antihypertensive medications can produce adverse sexual side effects, including impotence. It is important for the nurse to listen to the patient's concerns and avoid making value judgments. Other antihypertensive medications may manage this patient's blood pressure without causing adverse sexual effects. Reducing the undesired effects of antihypertensive medication will improve the patient's adherence. The nurse is caring for several patients being treated for hypertension. Which patient will the nurse assess first? The patient who has been on clonidine for 1 day The patient who is taking clonidine and furosemide The patient who is on clonidine and a thiazide diuretic The patient who has stopped taking clonidine because of cost- Abrupt discontinuation of the antihypertensive drug may cause rebound hypertension. The patient who has just been started on an antihypertensive drug and the patients who are on combinations of antihypertensive drugs will not be the highest priorities for assessment because they seem to be adhering to treatment. Abruptly discontinuing the drug indicates either a failure to understand the treatment or a nonadherence to treatment. A patient is prescribed a noncardioselective beta blocker. Which nursing intervention is a priority for this patient? Monitoring blood glucose levels Teaching about potential tachycardia Conducting a respiratory assessment- Assessing for orthostatic hypotension Non-cardioselective beta blockers (beta₂ blockers) can cause bronchoconstriction, therefore a respiratory assessment is indicated to check for airway compromise. Beta 1 Blood glucose monitoring and assessment for orthostatic hypotension in patients on beta blockers are appropriate nursing interventions, but are not higher priorities than a respiratory assessment, related to potential airway compromise. Tachycardia is not associated with use of beta blockers, therefore this teaching is not a priority. A patient has a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. During a review of the patient's list of current medications, which medication(s) would alert the nurse to a possible interaction with this new prescription? Select all that apply. Warfarin 5 mg by mouth daily Spironolactone 25 mg by mouth daily- Ibuprofen 400 mg by mouth twice daily- Alprazolam 0.25 mg by mouth twice a day Potassium chloride 20 mEq by mouth daily- Hyperkalemia may occur with any ACE inhibitor. Potassium supplementation and potassium-sparing diuretics such as spironolactone need to be used with caution. The use of nonsteroidal antiinflammatory drugs along with ACE inhibitors also may predispose patients to the development of acute renal failure. There is no interaction between ACE inhibitors and anticoagulants such as warfarin or benzodiazepines such as alprazolam. A nurse is reviewing the medication record of a patient with chronic kidney disease who developed hypertension. Which drugs will the nurse anticipate administering initially? Select all that apply. Beta blocker Aldosterone antagonist Angiotensin II receptor blocker- Calcium channel blocker (CCB) Angiotensin-converting enzyme (ACE) inhibitor- Recommendations for initial management of hypertension in patients with chronic kidney disease includes ACE inhibitors and angiotensin II receptor blockers. Beta blockers are recommended for patients with cardiac problems or diabetes. Aldosterone antagonists are recommended for heart failure and after myocardial infarction. CCBs are recommended for high coronary disease risk and diabetes. A nurse is preparing a prescribed medication to lower a hypertensive emergency in a patient. The provider states that this drug will maintain the patient's renal function. Which drug will the nurse administer? Labetalol Clevidipine Fenoldopam- Sodium nitroprusside Fenoldopam differs from other antihypertensives in that it helps maintain (or even improve) renal function. Labetalol, clevidipine, and sodium nitroprusside do not maintain or improve renal function. The patient with diabetes is diagnosed with hypertension. The nurse would instruct the patient to increase frequency of blood glucose monitoring if which medication(s) are prescribed for the patient? Select all that apply. Enalapril Diltiazem Metoprolol- Furosemide- Hydrochlorothiazide- Hydrochlorothiazide and furosemide promote hyperglycemia, and metoprolol suppresses glycogenolysis and can mask signs of hypoglycemia. Therefore, these medications should be administered with caution to patients with diabetes. Diltiazem and enalapril do not cause either of these effects. The nurse is teaching a patient about the side effects associated with doxazosin. Which statement by the patient indicates an understanding of the nurse's instructions? "I may experience an increase in hair growth as a side effect." "I'll notify the health care provider if I develop a persistent cough." "I'll make sure I include extra sources of potassium in my diet, such as bananas and baked potatoes." "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."- The most disturbing side effect of alpha blockers, such as doxazosin, is orthostatic hypotension, because it can affect the patient's safety. Patients should change positions slowly and carefully. Excessive hair growth is a side effect of minoxidil. Persistent cough is an adverse effect of angiotensin-converting enzyme inhibitors. Hypokalemia is a side effect of thiazides and loop diuretics, so additional sources of potassium should be incorporated into the diet. When giving antihypertensive medications, the nurse would assess for which potential causes of adverse reactions? Select all that apply. Obesity Anorexia Appetite suppressants- Use of oral contraceptives- Use of over-the-counter cold medications- When taking the patient history, identify drugs that can raise blood pressure or interfere with the effects of antihypertensive drugs. Drugs of concern include oral contraceptives, nonsteroidal antiinflammatory drugs, glucocorticoids, appetite suppressants, tricyclic antidepressants, monoamine oxidase inhibitors, cyclosporines, erythropoietin, alcohol, and nasal decongestants. The nurse teaches the patient about his essential hypertension. Which statement would be included in the teaching plan? Once you have surgery, this will go away." "This type of hypertension has a definitive cause." "This type of hypertension is not able to be treated." "The cause of your hypertension is unknown but treatable."- The specific cause of essential (primary) hypertension is unknown. Surgical treatment may cure secondary hypertension but not idiopathic hypertension. A patient taking clonidine for hypertension is being given discharge teaching about the therapy. Which information would be included in this teaching plan? This therapy will cause bruising." "Take this medication after dinner." "Do not drink alcohol when on this therapy."- "Ask your healthcare provider before taking aspirin." Alcohol and other central nervous system depressants can cause increased central nervous system depression when taken with adrenergic medications. The medication will not cause bruising and does not have to be taken after dinner. The health care provider decides the best approach for a particular patient with hypertension is to prescribe a drug that elicits vasodilation. The nurse knows that which drugs will be options for this patient? Select all that apply. Aliskiren Prazosin Clonidine Metoprolol Hydralazine Mecamylamine In order to improve hypertension, prazosin causes vasodilation. Hydralazine does so as well by relaxing smooth vascular muscle. Aliskiren works by reducing vasoconstriction rather than promoting vasodilation. Clonidine improves hypertension by decreasing sympathetic stimulation of the heart and blood vessels. Metoprolol works by decreasing heart rate and myocardial contractility, and mecamylamine is a ganglionic blockade that reduces sympathetic stimulation of the heart and blood vessels. What drug class is recommended as the initial treatment for hypertension?There are three main classes of medication that are usually in the first line of treatment for hypertension: 1. Calcium Channel Blockers (CCB) 2. Angiotensin Converting Enzyme inhibitors (ACE inhibitors or ACE-I) and Angiotensin Receptor Blockers (ARBs) 3. Diuretics.
What are the main classes of drug used to treat hypertension?The classes of blood pressure medications include:. Diuretics.. Beta-blockers.. ACE inhibitors.. Angiotensin II receptor blockers.. Calcium channel blockers.. Alpha blockers.. Alpha-2 Receptor Agonists.. Combined alpha and beta-blockers.. Which drug class is recommended as the first line set of choices for hypertension in patients with diabetes mellitus and microalbuminuria?In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them.
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Which drug class is prescribed as initial therapy for hypertension after myocardial infarction?
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