Term
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Definition
| an increase in blood pressure such that the systolic pressure is greater than 140 mmHg and the diastolic pressure is greater than 90 mmHg |
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Term
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Definition
| most common type, affecting 90% of persons with high blood pressure. |
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Term
| he exact origin of essential hypertension is unknown; however, contributing factors may include: 8 |
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Definition
| (1) a family history of hypertension, (2) hyperlipidemia, (3) African-American background, (4) diabetes, (5) obesity, (6) aging, (7) stress, and (8) excessive smoking and alcohol ingestion. |
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Term
| Ten percent of hypertension cases are related to renal and endocrine disorders and are classified as |
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Definition
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Term
| The______ regulate blood pressure via the renin-angiotensin-aldosterone system. |
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Definition
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Term
| _______ stimulates production of angiotensin II (a potent vasoconstrictor), which causes the release of aldosterone |
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Definition
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Term
| The baroreceptors in the aorta and carotid sinus and the vasomotor center in the medulla also assist in the regulation of ______ _____. |
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Definition
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Term
| Other hormones that contribute to ____ ____ ____ are the antidiuretic hormone (ADH), atrial natriuretic peptide (hormone) (ANP), and brain natriuretic peptide (BNP). |
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Definition
| blood pressure regulation |
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Term
| is produced by the hypothalamus and is stored and released by the posterior pituitary gland (neurohypophysis). |
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Definition
| antidiuretic hormone (ADH |
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Term
| Alcohol increases _____ secretions, causing the production of angiotensin II. |
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Definition
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Term
| ____Americans are more likely to develop hypertension at an earlier age than ____ Americans. |
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Definition
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Term
| The use of beta-adrenergic blockers (beta blockers) and angiotensin-converting enzyme (ACE) inhibitors is less effective for the control of hypertension in ___ ____ unless the drug is combined or given with a diuretic |
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Definition
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Term
| Renin, an enzyme located in the juxtaglomerular cells of the kidney, is released when _____ ____ ____ |
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Definition
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Term
| ______ ______ are twice as sensitive as whites to beta blockers and other antihypertensives. |
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Definition
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Term
| One of the troublesome side effects of the use of antihypertensive agents in older adults, especially frail or institutionalized persons, is ______ _____ |
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Definition
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Term
| There are many nonpharmacologic ways to decrease blood pressure including: |
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Definition
| (1) stress-reduction techniques, (2) exercise (increases high-density lipoproteins [HDL]), (3) salt restriction, (4) decreased alcohol ingestion, and (5) weight reduction |
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Term
| DEFINE the 3 main hypertension levels . |
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Definition
| Prehypertension defined as a systolic blood pressure (SBP) 120 to 139 and a diastolic blood pressure (DBP) 80 to 89. Stage 1 hypertension falls between 140/90 and 159/99, and stage 2 hypertension is 160/100 or greater |
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Term
| Antihypertensive drugs, used either singly or in combination with other drugs, are classified into six categories |
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Definition
| (1) diuretics, (2) sympatholytics (sympathetic depressants), (3) direct-acting arteriolar vasodilators, (4) ACE inhibitors, (5) angiotensin II receptor blockers (ARBs), and (6) calcium channel blockers. |
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Term
| _______ diuretics should not be used for clients with renal insufficiency (creatinine clearance less than 30 mL/min). |
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Definition
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Term
| sympatholytics comprise five groups of drugs |
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Definition
| (1) beta-adrenergic blockers, (2) centrally acting alpha2 agonists, (3) alpha-adrenergic blockers, (4) adrenergic neuron blockers (peripherally acting sympatholytics), and (5) alpha1- and beta1-adrenergic blockers. Beta-adrenergic |
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Term
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Definition
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Term
| ____ _____ _____ are used as antihypertensive drugs or in combination with a diuretic. |
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Definition
| Beta-adrenergic blockers, frequently called beta blockers, |
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Term
| Beta (β+ and β–)-adrenergic blockers _____ cardiac output by diminishing the sympathetic nervous system response to ______ basal sympathetic tone. |
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Definition
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Term
| ___ ____ should not be used by clients with second- or third-degree atrioventricular (AV) block or sinus bradycardia. |
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Definition
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Term
| The nonselective beta blockers block ____ and ____- receptors, which can result in bronchial constriction. |
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Definition
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Term
| Noncardioselective beta blockers inhibit the liver's ability to convert glycogen to glucose in response to _______ |
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Definition
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Term
| beta1 blocker contraindications |
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Definition
| Second- and third-degree heart block, cardiogenic shock, HF, sinus bradycardia. NOTE: metoprolol and carvedilol may be prescribed for early use in management of chronic HF |
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Term
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Definition
| Fatigue, weakness, dizziness, nausea, vomiting, diarrhea, mental changes, nasal stuffiness, impotence, decreased libido, depression |
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Term
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Definition
| Bradycardia, thrombocytopenia Life-threatening: Complete heart block, bronchospasm, agranulocytosis |
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Term
| Centrally acting alpha2 agonists decrease the ___ ___ from the brainstem to the peripheral vessels. |
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Definition
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Term
| Centrally acting alpha2 agonists have what affect on the body? |
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Definition
| increases vagus activity; decreases cardiac output; and decreases serum epinephrine, norepinephrine, and renin release. |
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Term
| ____ _____ are not given with centrally acting sympatholytics, because accentuation of bradycardia during therapy and rebound hypertension on discontinuing therapy can occur. |
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Definition
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Term
| Side effects of alpha2 agonists include |
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Definition
| rowsiness, dry mouth, dizziness, and slow heart rate (bradycardia). |
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Term
| Alpha-Adrenergic Blockers |
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Definition
| This group of drugs blocks the alpha-adrenergic receptors (alpha blockers), resulting in vasodilation and decreased blood pressure. |
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Term
| This drug helps maintain the renal blood flow rate. |
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Definition
| Alpha-Adrenergic Blockers |
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Term
| The ____ ____ ____ are used mainly to reduce blood pressure and can be used to treat benign prostatic hypertrophy (BPH |
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Definition
| alpha1-adrenergic blockers |
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Term
| Selective alpha-adrenergic blockers _____ the arterioles and venules, ______peripheral resistance and _____ blood pressure. |
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Definition
| dilate, decreasing, lowering |
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Term
| Drug interactions occur when ____ ____ blockers are taken with antiinflammatory drugs and nitrates |
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Definition
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Term
| _______ ________ blockers are potent antihypertensive drugs that block norepinephrine release from the sympathetic nerve endings, causing a decrease in norepinephrine release that results in a lowering of blood pressure |
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Definition
| Adrenergic Neuron Blockers (Peripherally Acting Sympatholytics) |
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Term
| The adrenergic neuron blockers are considered the last choices for treatment of chronic hypertension, because these drugs can cause: |
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Definition
| orthostatic (postural) hypotension. |
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Term
| alpha-adrenergic blocker side effects: |
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Definition
| Dizziness, drowsiness, headache, nausea, vomiting, diarrhea, impotence, vertigo, urinary frequency, tinnitus, dry mouth, incontinence, abdominal discomfort |
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Term
| Angiotensin-Converting Enzyme (Ace) Inhibitors |
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Definition
| Drugs in this group inhibit ACE, which in turn inhibits the formation of angiotensin II (vasoconstrictor) and blocks the release of aldosterone. Aldosterone promotes sodium retention and potassium excretion. When aldosterone is blocked, sodium is excreted along with water, and potassium is retained. |
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Term
| ACE inhibitor contraindications |
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Definition
| should not be given during pregnancy; harm to the fetus due to reduction in placental blood flow could occur. This group of drugs should not be taken with potassium-sparing diuretics such as spironolactone (Aldactone) or salt substitutes that contain potassium, |
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Term
| Slow calcium channels are found in the ______ and ____ ____ ___ cells |
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Definition
| myocardium (heart muscle), vascular smooth muscle (VSM |
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Term
| Calcium channel blockers do what? |
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Definition
| block the calcium channel in the VSM, promoting vasodilation. |
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Term
| Normally _____ blockers are not prescribed with _____ blockers, because both drugs decrease myocardium contractility |
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Definition
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Term
| The side effects and adverse reactions of calcium channel blockers include |
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Definition
| flush, headache, dizziness, ankle edema, bradycardia, and AV block. |
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Term
1. A client's blood pressure (BP) is 145/90. According to the guidelines for determining hypertension, the nurse realizes that the client's BP is at which stage?
a. Normal
b. Prehypertension
c. Stage 1 hypertension
d. Stage 2 hypertension |
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Definition
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Term
2. The nurse acknowledges that the first-line drug for treating this client's blood pressure might be which drug?
a. Diuretic
b. Alpha blocker
c. ACE inhibitor
d. Alpha/beta blocker |
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Definition
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Term
3. The nurse is aware that which group(s) of antihypertensive drugs are less effective in African-American clients?
a. Diuretics
b. Calcium channel blockers and vasodilators
c. Beta blockers and ACE inhibitors
d. Alpha blockers |
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Definition
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Term
4. The nurse knows that which diuretic is most frequently combined with an antihypertensive drug?
a. chlorthalidone
b. hydrochlorothiazide
c. bendroflumethiazide
d. potassium-sparing diuretic |
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Definition
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Term
5. The nurse explains that which beta blocker category is preferred for treating hypertension?
a. Beta1 blocker
b. Beta2 blocker
c. Beta1 and beta2 blockers
d. Beta2 and beta3 blockers |
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Definition
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Term
6. Captopril (Capoten) has been ordered for a client. The nurse teaches the client that ACE inhibitors have which common side effects?
a. Nausea and vomiting
b. Dizziness and headaches
c. Upset stomach
d. Constant, irritating cough |
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Definition
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Term
7. A client is prescribed losartan (Cozaar). The nurse teaches the client that an angiotensin II receptor blocker (ARB) acts by doing what?
a. Inhibiting angiotensin-converting enzyme
b. Blocking angiotensin II from AT1 receptors
c. Preventing the release of angiotensin I
d. Promoting the release of aldosterone |
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Definition
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Term
8. During an admission assessment, the client states that she takes amlodipine (Norvasc). The nurse wishes to determine whether or not the client has any common side effects of a calcium channel blocker. The nurse asks the client if she has which signs and symptoms? (Select all that apply.)
a. Insomnia
b. Dizziness
c. Headache
d. Angioedema
e. Ankle edema
f. Hacking cough |
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Definition
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