HW Ch 41 42 (11 ed)_-136928969

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University of Wisconsin, Madison *

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Chemistry

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Nov 24, 2024

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Ch 41 Diuretics 1. a. Decrease hypertension b. Decrease edema - in heart failure and renal or liver disorders 2. They block sodium as well as chloride reabsorption (in kidney) 3. They are not effective for immediate diuresis 4. To avoid sleep disturbances 5. Dizziness may occur as a result of orthostatic (postural) hypotension. 6. Hypokalemia or serum potassium levels -Signs of Hypokalemia include: muscle weakness, leg cramps, and cardiac dysrhythmias. 7. Normal levels: Potassium, 3.5–5.0 mEq/L 8. Potassium supplementation while using a potassium-wasting diuretic 9. The most serious drug interaction with thiazides- digoxin symptoms of this interaction that should be reported Bradycardia, vomiting, nausea, or visual changes 10. Loop diuretics to thiazides are more potent than thiazides for promoting diuresis, inhibiting reabsorption of sodium two to three times more effectively, loop diuretics are less effective as antihypertensive agents 11. Skin reactions common to thiazides and loop diuretics a. Rash b. Injection site reaction 12. hormone aldosterone a. Retention of sodium and water causes fluid volume to increase, elevating blood pressure the drug spironolactone Inhibits aldosterone effects on distal renal tubules to promote sodium and water excretion and potassium retention

13. Nausea, vomiting, diarrhea, abdominal cramps, dizziness, drowsiness, headache, confusion, weakness, muscle cramps, gout, paresthesia, dehydration, ataxia, erectile dysfunction. 14. Emergency Use of Mannitol: For edema, cerebral edema, IOP, increased ICP, acute renal failure, and excretion of toxic substances. 15. IV mannitol may crystalize. Explain how to manage this risk Should be kept in a warm compartment Ch 42 Antihypertensives 16. A troublesome side effects of the use of antihypertensive agents in older adults, especially frail or institutionalized persons, is orthostatic (postural) hypotension. 17. The drug class that is effective as a first-line drug for treating mild hypertension is beta blockers. 18. The action of beta blockers on: heart rate: decrease contractility: decrease 19. Cardioselective beta blockers are preferred because they act mainly on the beta 1. 20. Side effects and adverse reactions to beta blockers include decreased pulse rate, markedly decreased BP, and, with noncardioselective beta1 and beta2 blockers, bronchospasm 21. Beta blockers should not be discontinued abruptly because rebound hypertension, dysrhythmias, angina and MI. 22. For beta blockers, the nursing process regarding taking the pulse involves: measuring their heart rate before giving them the medicine, monitoring changes in heart rate, and documenting the results. The nurse should note possible adverse effects of beta-blockers, including low blood pressure, dizziness, and should alert the healthcare practitioner to any alarming symptoms. 23. Alpha-adrenergic blockers Lower blood pressure by relaxing the blood vessels (arterioles and venules) and allowing more blood to flow through them (peripheral resistance drops).

24. List a. reduces the production of angiotensin II b. Blocks the release of aldosterone 25. The primary side effect of ACE inhibitors is constant, irritated cough Management: Discontinuing of the drug 26. Two other major adverse effects of ACEIs are first -dose hypotension and hyperkalemia 27. Two contraindications for ACEIs: a. Pregnancy, b. potassium-sparing diuretics 28. The action of calcium channel blockers on vascular smooth muscle: Promote vasodilation 29. Side effects and adverse reactions of the CCBs a. Flushing b. Bradycardia c. ankle edema, d. dizziness e. headache, f. and AV block

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