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NRSE 3010 ETSU College of NursingStudy Guide Exam 2 Spring 2024
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NRSE 3010 ETSU College of NursingStudy Guide Exam 2 Spring 2024
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1ETSU/College of Nursing
Study Guide Exam 2 Spring 2017
NRSE 3010
This will serve as a guide to help you prepare for the second exam. This is a guide and there
may be content covered in class reflected in the exam not specifically listed on the study guide.
Chapters:, 41, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 58, 59
– Calcium Channel Blockers
1. Nifedipine (Procardia)
Adverse Effects
Monitor for hypotension (increase fall risk); edema (peripheral edema occurring
2-3 weeks after starting med)
Nursing considerations (teaching, administration concerns, etc.)
• Monitor for hypotension (orthostatic – increased risk for falls)
• Swelling of lower extremities
• Instruct to NOT take with grapefruit juice (enhance absorption and alter
therapeutic drug level)
Drug interactions
Avoid grapefruit (enhance absorption and alter therapeutic drug level)
ACE inhibitors and Alpha 1 blockers
• Mechanism of Action
• Blocks calcium in the vascular smooth muscle (smooth muscle relaxer) and
promotes vasodilation
• Very little effect on the heart
• More likely to cause reflex tachycardia (can combine with Beta Blocker (such as
metoprolol) to prevent)~
• Therapeutic Uses of Nifidepine
Angina
HTN
Suppress preterm labor (investigational)
2. Verapamil (Calan)
Mechanism of action
• Blocks calcium in the vascular smooth muscle (smooth muscle relaxer)
and promotes vasodilation
Therapeutic uses
Adverse Effects
Nursing considerations (teaching, administration concerns, etc.)
Drug interactions
Beta blockers
Grapefruit juice
, 2
– Renin-Angiotensin-Aldosterone System (RAAS)
Angiotensin-Converting Enzyme inhibitors (ACE inhibitors)
• The RAAS is a key mechanism in controlling BP and fluid balance
• Angiotensinogen is synthesized in the liver
• Cleaved by enzymes to form angiotensin I
• Angiotensin I is cleaved by ACE to form angiotensin II
• Angiotensin II is a potent vasoconstrictor
ACE inhibitors (Lisinopril) “the pril “ sisters”
Mechanism of action
Reducing levels of angiotensin II and increasing levels of bradykinin
Therapeutic uses
• Slows progression of heart failure
• Lower mortality of recent acute MI
• Prophylaxis for adverse cardiac events
• Prevent or delay progression of renal disease and retinopathy of diabetics
Adverse Effects (Hint: most common)
• Cough~
• Angioedema – potentially fatal ~BBW
• First Dose Hypotension
• Hyperkalemia (retention of potassium from aldosterone retention
• Renal failure – ACE I decreases GFR
• Fetal injury – Category D
• Primary excretion – renal (contraindicated in renal failure)
• Onset of Action: 1 hour
• Peak effect: 6 – 8 hours
Nursing considerations (teaching, administration concerns, etc.)
• Monitor for hypotension
• Monitor for angioedema
• Monitor for cough
• Instruct to limit use of salt substitutes (these usually contain potassium)
• Inform PCP if becomes pregnant
Drug interactions
• Diuretics – intensity effects
• Antihypertensive medications – intensify hypotensive effects
• Drugs that raise potassium levels
• Lithium toxicity accumulation of Lithium
• NSAID –may reduce antihypertensive effects of ACE I
Pregnancy category
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