NUR 2474 Exam 2: Pharmacology for Professional
Nursing Exam 2 (Latest ) Rasmussen
Hypertension BP150/90 crackles bibasilar, 2+ edema, distended jugular veins -
ANSWER -Expect order furosemide (loop diuretic)
Diabetes mellitus and hypertension - ANSWER -Anticipate order for ace inhibitor
Patient has cough for 3 days that is non productive after starting lisinopril -
ANSWER -Stop lisinopril and start losartan
Angiotensin II Receptor Blockers (ARBs) - ANSWER -DO NOT promote
accumulation of bradykinin in the lung and therefore have lower instance of cough
Losartan - ANSWER -is an angiotensin 2 receptor blocker adverse effects are
angioedema, fetal harm and renal failure
Patient with 2+ pitting edema In bilateral lower extremities, bibasilar crackles and
potassium of 6 - ANSWER -Question it if Dr orders spironolactone which is a
potassium sparing drug
APTT normal levels - ANSWER -40 seconds (60 to 80 if on heparin)
Methyldopa and labetalol - ANSWER -are drugs of choice for treating chronic
hypertension of pregnancy
Hypertension is the most common complication of - ANSWER -pregnancy
Nitroprusside (IV) - ANSWER -is the drug of choice for hypertensive
emergencies
A severe hypertensive emergency exists when diastolic - ANSWER -Diastolic BP
exceeds 120 mm Hg and there is ongoing end organ damage
, Lack of patient adherence - ANSWER -is the major cause of treatment failure in
antihypertensive therapy
Dosages of antihypertensive drugs - ANSWER -should be low initially and
increased gradually. This approach minimizes adverse effects and permits
baroreceptors to rest to a lower pressure
When a combination of a drug is used - ANSWER -each drug should have a
different mechanism of action
Thiazide diuretics - ANSWER -are preferred drugs for initial therapy of
uncomplicated hypertension
Aldosterone antagonists lower BP by - ANSWER -Preventing aldosterone
mediated retention of sodium and water in the kidneys
Calcium channel blockers (diltiazem, nifedipine) reduce BP by - ANSWER -
promoting dilation of arterioles
Untreated hypertension can lead to - ANSWER -heart disease, kidney disease, and
stroke
Patients older than 50 elevated systolic BP - ANSWER -represents a greater
cardiovascular risk than elevated diastolic BP
Primary hypertension (essential hypertension) - ANSWER -defined as
hypertension with no identified cause is the most common form of hypertension.
The goal of antihypertensive therapy - ANSWER -is to decrease morbidity and
mortality without decreasing quality of life. For most patients this goal is achieved
by maintaining a BP of between 120/80 and 130/80 mm Hg
Diltiazem - ANSWER -is used for treating dysrhythmias
, Hypertension is defined as - ANSWER -SBP greater than 130 mm Hg or DBP
greater than 80 mm Hg.
To reduce BP, two types of treatment may be used - ANSWER -drug therapy and
lifestyle modification (smoking cessation, reduction of salt and alcohol intake,
following the DASH diet, and increasing aerobic exercise).
Thiazide diuretics and loop diuretics reduce BP in two ways - ANSWER -they
reduce blood volume (by promoting diuresis) and they reduce arterial resistance
(by an unknown mechanism).
Loop diuretics should be reserved for - ANSWER -(1) patients who need greater
diuresis than can be achieved with thiazides and (2) patients with a low GFR
(because thiazides do not work when GFR is low).
Adherence is difficult to achieve because - ANSWER -(1) hypertension has no
symptoms (so drug benefits are not obvious); (2) hypertension progresses slowly
(so patients think they can postpone treatment); and (3) treatment is complex and
expensive, continues lifelong, and can cause adverse effects.
ACE inhibitors, ARBs, and DRIs lower BP by - ANSWER -preventing
angiotensin II-mediated vasoconstriction and aldosterone-mediated volume
expansion. ACE inhibitors work by blocking the formation of angiotensin II,
whereas ARBs block the actions of angiotensin II. DRIs prevent formation of
angiotensin I and thereby shut down the entire RAAS.
Beta blockers (e.g., metoprolol) - ANSWER -appear to lower BP primarily by
reducing peripheral vascular resistance; the mechanism is unknown. They may also
lower BP by decreasing myocardial contractility and suppressing reflex
tachycardia (through beta1-blockade in the heart) and by decreasing renin release
(through beta1-blockade in the kidney).
The baroreceptor reflex, the kidneys, and the RAAS - ANSWER -can oppose our
attempts to lower BP with drugs. We can counteract the baroreceptor reflex with a
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