NSG 229 Exam 1 STUDY GUIDE QUESTIONS WITH
COMPLETE SOLUTIONS
Alternative antihypertensive drugs
•Beta Adrenergic blocker
•Alpha 2-adrenergic agonists
•Direct-Acting vasodilators
•Peripheral adrenergic antagonists
Diuretics for HTN:
•Thiazide Diuretic
•Prototype: hydrochlorthiazide
•Potassium-Sparing Diuretic
•Prototype: spironolacton (Aldactone)
•Loop Diuretic
•Prototype: furosemide (Lasix)
NSG Considerations:
-Watch for hypotension
-Watch for hypokalemia
-Monitor uric acid levels
-Administer early in day
-Monitor Glucose levels
Ca Channel Blockers
,Nifedipine (Procardia)
Diltiazem (Cardizem)
Amlodipine (Norvasc)
Verapamil (calan)
-Inhibit Ca++ from entering cell, therefore reducing muscular
contraction
also relax smooth muscle, lowering peripheral resistance
-Good for African Americans and elderly where other meds
don’t work
-Grapefruit juice enhances absorption
-May cause peripheral edema
ACE inhibitors
Captopril (Capoten)
Enalapril (Vasotec)
Lisinopril (Zestril)
Quinapril (Accupril)
-Prevents conversion of Angiotensin II, a potent vasoconstrictor
-1st dose hypotension
-Angioedema and neutropenia are life threatening side
effects
-Dry cough is common with these meds
-Hyperkalemia
,Angiotensin II blockers
Losartan (Cozaar)
Valsartan (Diovan)
Candesartan (Atacand)
-Blocks receptors for angiotensin II in arteriolar smooth muscle
and in adrenal gland producing BP to fall
-Very few side effects except for hypotension
-Hyperkalemia
Beta-adrenergic blockers
Atenolol
Metoprolol
Propranolol
Carvedilol
Labetalol
-Work by ↓ HR and contractility, therefore ↓ CO and ↓ BP
-Monitor for bradycardia and orthostatic hypotension (hold for
BP <100Sys and HR <60)
-Cautious use in pts with asthma b/c of bronchoconstriction
-Use with caution in pts with DM
Alpha2-adrenergic agonists
clonidine
methyldopa
, -Decrease the outflow of sympathetic nerve impulses from the
CNS→produces ↓HR and dilation arterioles
-Side effects: dizziness and sedation, low HR
-methyldopa (Aldomet) is OK to use in pregnancy
-Centrally acting and have multiple side effects, used only if
other drugs aren’t working
Direct acting Vasodilators
hydralazine
nitroprusside
-causes direct relaxation of vascular smooth muscle but have
serious side effects
-- Reflex tachycardia Na and H20 retention
-nitroprusside is metabolized into cyanide
--Think of the liver and kidney function of the patient
-Used in emergency situations only b/c of rapid drop in BP (no
more than 25% in 2-6 hours)—gradual reduction is preferred
Types of peripheral lines
Midlines- Longer catheter usually placed in upper arm for
difficult or longer term access (~1-4 weeks)
Short Peripheral Catheter- Common “regular” IV
Arterial Line- Used for hemodynamic monitoring or frequent
blood draws
Types of central lines
COMPLETE SOLUTIONS
Alternative antihypertensive drugs
•Beta Adrenergic blocker
•Alpha 2-adrenergic agonists
•Direct-Acting vasodilators
•Peripheral adrenergic antagonists
Diuretics for HTN:
•Thiazide Diuretic
•Prototype: hydrochlorthiazide
•Potassium-Sparing Diuretic
•Prototype: spironolacton (Aldactone)
•Loop Diuretic
•Prototype: furosemide (Lasix)
NSG Considerations:
-Watch for hypotension
-Watch for hypokalemia
-Monitor uric acid levels
-Administer early in day
-Monitor Glucose levels
Ca Channel Blockers
,Nifedipine (Procardia)
Diltiazem (Cardizem)
Amlodipine (Norvasc)
Verapamil (calan)
-Inhibit Ca++ from entering cell, therefore reducing muscular
contraction
also relax smooth muscle, lowering peripheral resistance
-Good for African Americans and elderly where other meds
don’t work
-Grapefruit juice enhances absorption
-May cause peripheral edema
ACE inhibitors
Captopril (Capoten)
Enalapril (Vasotec)
Lisinopril (Zestril)
Quinapril (Accupril)
-Prevents conversion of Angiotensin II, a potent vasoconstrictor
-1st dose hypotension
-Angioedema and neutropenia are life threatening side
effects
-Dry cough is common with these meds
-Hyperkalemia
,Angiotensin II blockers
Losartan (Cozaar)
Valsartan (Diovan)
Candesartan (Atacand)
-Blocks receptors for angiotensin II in arteriolar smooth muscle
and in adrenal gland producing BP to fall
-Very few side effects except for hypotension
-Hyperkalemia
Beta-adrenergic blockers
Atenolol
Metoprolol
Propranolol
Carvedilol
Labetalol
-Work by ↓ HR and contractility, therefore ↓ CO and ↓ BP
-Monitor for bradycardia and orthostatic hypotension (hold for
BP <100Sys and HR <60)
-Cautious use in pts with asthma b/c of bronchoconstriction
-Use with caution in pts with DM
Alpha2-adrenergic agonists
clonidine
methyldopa
, -Decrease the outflow of sympathetic nerve impulses from the
CNS→produces ↓HR and dilation arterioles
-Side effects: dizziness and sedation, low HR
-methyldopa (Aldomet) is OK to use in pregnancy
-Centrally acting and have multiple side effects, used only if
other drugs aren’t working
Direct acting Vasodilators
hydralazine
nitroprusside
-causes direct relaxation of vascular smooth muscle but have
serious side effects
-- Reflex tachycardia Na and H20 retention
-nitroprusside is metabolized into cyanide
--Think of the liver and kidney function of the patient
-Used in emergency situations only b/c of rapid drop in BP (no
more than 25% in 2-6 hours)—gradual reduction is preferred
Types of peripheral lines
Midlines- Longer catheter usually placed in upper arm for
difficult or longer term access (~1-4 weeks)
Short Peripheral Catheter- Common “regular” IV
Arterial Line- Used for hemodynamic monitoring or frequent
blood draws
Types of central lines
