Ch.16 Pharm

Which term means high blood pressure from no known cause?

primary hypertension

What condition is a major cause of long-term high blood pressure?

Atherosclerosis

What types of over-the-counter drugs can worsen high blood pressure?

Drugs for asthma

How do most diuretics lower blood pressure?

Promoting water and sodium loss

How do angiotensin-converting enzyme (ACE) inhibitors lower blood pressure?

Relaxing blood vessel muscles

Which side effect of ACE inhibitors is very common?

Dry, hacking cough

What is a possible life-threatening adverse effect that can occur when a person is taking an ACE inhibitor?

Angioedema

What substance should patients taking ACE inhibitors avoid?

Salt substitutes

Which drug is an angiotensin II receptor blocker (ARB)?

Losartan

Which condition can be a severe adverse reaction to angiotensin II receptor blockers?

Kidney failure

How do calcium channel blockers help to lower blood pressure?

Relaxing arteries and slowing heart contractions

What side effect is common to calcium channel blockers?

Leg and ankle swelling

Which drug for high blood pressure is a beta blocker?

Propranolol

Which condition is a possible severe adverse effect of beta blockers?

Difficulty breathing

How do alpha blockers work to lower blood pressure?

Relaxing blood vessel muscles

What are the most common side effects of alpha blockers?

Dizziness and drowsiness

Which drug acts directly on the peripheral arteries, causing them to dilate and leading to decreased blood pressure?

Minoxidil (Loniten)

Which class of antihypertensive drugs has a higher incidence of side effects?

Direct vasodilators

A patient's blood pressure is consistently around 138/88 mm Hg. What does this reading represent?

Prehypertension

What is the difference between primary hypertension and secondary hypertension?

Secondary hypertension is caused by another health problem, whereas primary hypertension does not have a known cause.

You are teaching a patient about antihypertensive therapy. Which statement by the patient indicates the need for more teaching?

Now that my blood pressure is normal, I won't need to take my medication anymore.

Which drug action is most likely to lower blood pressure?

Relaxing (dilating) blood vessel smooth muscle

Which action or precaution is most important for before giving any type of drug for hypertension?

Check the patient's blood pressure.

You are checking a patient's blood pressure before administering an antihypertensive. The reading of 88/52 mm Hg. What is your best action?

Hold the dose and notify the prescriber.

You give the first dose of an antihypertensive drug to a hospitalized patient. Which instruction should you give to the patient next?

Stay in bed and call for help if you need to get up for any reason.

A patient prescribed a thiazide diuretic for hypertension reports having cramps and feeling like the heart is skipping beats. What side effect of this drug do you suspect?

Hypokalemia

A patient taking a thiazide diuretic has the following blood laboratory values for kidney function. Which value will you report to the prescriber immediately?

Sodium 124 mEq/L

A patient asks you how atenolol (Tenormin) will help reduce hypertension. What is your best response?

It will decrease your heart rate and how hard your heart pumps.

A patient taking metoprolol (Lopressor) for hypertension reports all of the following side effects. For which side effect will you notify the prescriber

Chest pain during exercise

Which precaution is most important for you to teach a patient who has been prescribed a beta blocker drug for hypertension?

Do not suddenly stop taking this drug without notifying your prescriber.

A 38-year-old patient has been prescribed nadolol (Corgard) 80 mg daily for hypertension. The patient tells you that he has stopped taking the drug. What is your best first action at this time?

Ask the patient if he is experiencing side effects of the drug.

A patient has a dose of labetalol (Normodyne) ordered twice a day and is due to have an exercise stress test this morning. What is your best action at this time?

Hold the dose and notify the prescriber.

For which patient is labetalol (Normodyne) contraindicated as an antihypertensive drug?

60-year-old man with severe asthma

A patient who has been prescribed enalapril (Vasotec) has developed a persistent nonproductive cough. What is your best action?

Hold the dose and notify the prescriber.

A patient who has been taking lisinopril (Zestril) develops swollen lips and reports that the tongue feels thick. What is your best action?

Hold the lisinopril dose and notify the prescriber.

An older patient has been prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which precaution is most important for you to teach the patient about this drug?

Change positions slowly when rising up from a sitting position.

You are to give the first dose of enalapril (Vasotec) to a patient whose medication reconciliation indicates he also takes furosemide (Lasix) for hypertension. What action should you take?

Administer both drugs as prescribed.

A patient has been prescribed losartan (Cozaar). Which substance, drug, or activity do you teach the patient to avoid?

Salt substitutes

How does the drug diltiazem (Cardizem) lower blood pressure?

Widens small arteries.

An older adult man who takes verapamil (Calan) reports that his breasts have enlarged. What is your best action?

Document the response and reassure the patient that this is a common side effect.

A patient who is taking nicardipine (Cardene) develops skin lesions, itching, fever, and achy joints. What is your best first action?

Hold the drug and notify the prescriber.

You are teaching a patient who has just been prescribed prazosin (Minipress) for hypertension. You immediately notify the prescriber and question the order upon discovering that the patient is also taking which drug?

Sildenafil (Viagra)

A patient with hypertension is prescribed terazosin (Hytrin). When should you administer the first dose of this drug to the patient?

At bedtime

A patient with hypertension and type 2 diabetes mellitus is taking carvedilol (Coreg). What special precaution should you teach the patient to take when taking this drug?

Check blood sugar levels regularly.

You are teaching a patient how to administer clonidine (Catapres) using the transdermal patch system. How often do you teach the patient to change the patch?

Every 7 days

Which antihypertensive drug would you teach a patient is considered safe for use during pregnancy or breastfeeding?

Methyldopa (Aldomet)

Which statement by a patient prescribed enalapril (Vasotec) indicates the need for additional teaching?

I will use a salt substitute instead of table salt when I eat.

A 33-year-old female patient is currently taking captopril (Capoten) and metoprolol (Lopressor) to control her blood pressure. She tells you that she plans to become pregnant. What should you teach the patient about the use of this drug during pregnancy?

ACE inhibitors should not be prescribed for women who are pregnant.

A hospitalized patient prescribed nifedipine XL (Procardia) 60 mg once a day informs you that at home he was taking nicardipine (Cardene) 20 mg three times a day and thinks this is the wrong drug. What is your best action?

Hold the drug and contact the prescriber to clarify the order because of the patient's concern before administering the dose.

An adult patient is prescribed metoprolol (Lopressor) 50 mg orally twice a day. Metoprolol is available in 100 mg tablets. How many tablets will you give for each dose?

0.5