Which adverse effect will the nurse monitor for in a patient who is receiving nifedipine?
Antihypertensive drugs affect different areas of blood pressure control so in most cases, these agents are combined for synergistic effect. Show
Ninety percent of cases of hypertension have no known cause. Therefore, the main action of antihypertensive agents is to alter the body’s regulating mechanisms (e.g. baroreceptors, renin-angiotensin-aldosterone system, etc.) responsible for maintaining normal blood pressure. Different people have different responses towards hypertensive agents because hypertension is multifactorial. For an instance, the presence of comorbidities (e.g. diabetes, myocardial infarction, etc.) may make some antihypertensives not suitable for treatment.
Antihypertensive Agents: Generic and Brand NamesHere is a table of commonly encountered antihypertensive drugs, their generic names, and brand names:
Disease Spotlight: HypertensionHypertension affects 20% of the population of the United States alone. Types Ninety percent of these cases have no known cause and is termed as essential hypertension. Of this type, there is elevated total peripheral resistance. Also, the organs are perfused effectively and people with essential hypertension usually exhibit no symptoms. It is also the reason why hypertension is tagged as the “silent killer.” Another type of hypertension called secondary hypertension is characterized by elevated blood pressure due to a known cause. For example, a tumor in the adrenal medulla called phaeochromocytoma can cause the organ to release a high amount of catecholamines, which greatly increase blood pressure. Categories A category rating the severity of hypertension has been devised and the classifications of blood pressure are as follows:
ACE Inhibitors
Therapeutic Action
Indications
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Nursing ConsiderationsHere are important nursing considerations when administering this drug: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing DiagnosesHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy:
Implementation with RationaleThese are vital nursing interventions done in patients who are taking ACE inhibitors:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Angiotensin II-Receptor Blockers
Therapeutic Action
Indications
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Nursing ConsiderationsHere are important nursing considerations when administering ARBs: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing DiagnosesHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy:
Implementation with RationaleThese are vital nursing interventions done in patients who are taking ARBs:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Calcium-Channel Blockers
Therapeutic Action
Indications
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Nursing ConsiderationsHere are important nursing considerations when administering calcium-channel blockers: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing DiagnosesHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy:
Implementation with RationaleThese are vital nursing interventions done in patients who are taking calcium-channel blockers:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Vasodilators
Therapeutic Action
Indications
Pharmacokinetics
Contraindications and Cautions
Adverse Effects
Interactions
Nursing ConsiderationsHere are important nursing considerations when administering direct vasodilators: Nursing AssessmentThese are the important things the nurse should include in conducting assessment, history taking, and examination:
Nursing DiagnosesHere are some of the nursing diagnoses that can be formulated in the use of this drug for therapy:
Implementation with RationaleThese are vital nursing interventions done in patients who are taking vasodilators:
EvaluationHere are aspects of care that should be evaluated to determine effectiveness of drug therapy:
Practice Quiz: Antihypertensive AgentsQuiz time! Just how much you’ve learned from our nursing pharmacology study guide for Antihypertensive Agents? Take the 5-item quiz below and find out! 1. The three primary elements that determine the pressure in the cardiovascular system are heart rate, stroke volume, and: A. Baroreceptors 2. Untreated hypertension can result to which of the following: A. Stroke 3. A student nurse was asked to take the blood pressure of a patient in the emergency room. The BP reads 140/90 mmHg. She would be correct to say that this BP belongs to ____________ classification. A. Normal 4. Which of the following medications will decrease the therapeutic effects of quinapril (Accupril)? A. NSAIDs 5. A patient receiving nitroprusside begun manifesting headache, distant heart sounds, imperceptible pulses, and shallow breathing. The nurse knows that these are signs of? A. Reflex tachycardia Answers and Rationale 1. Answer: B. Peripheral resistance. Small arterioles help regulate blood pressure in a constant basis and are the most important factor affecting peripheral resistance. When small arterioles constrict, they are almost able to stop the flow of the blood. Their high responsiveness to sympathetic nervous stimulation cause them to constrict and increase blood pressure. Baroreceptors are pressure receptors located in the arch of the aorta and carotid arteries that send information to the brain when pressure increases. RAAS is a compensatory mechanism activated in the kidney when blood pressure falls. 2. Answer: D. All of the above. The force of the blood propelled against blood vessels can damage their linings, making them susceptible to atherosclerosis and narrowing. When these happen, tiny vessels in the retina, kidneys, and brain can be destroyed leading to unresponsiveness of the system. 3. Answer: D. Stage 2 Hypertension A category rating the severity of hypertension has been devised and the classifications of blood pressure are as follows: Normal – systolic: <120 mmHg; diastolic: <80 mmHg; Elevated – systolic: 120-129 mmHg; diastolic: <80 mmHg; Stage 1 Hypertension – systolic: 130-139 mmHg; diastolic: 80-89 mmHg; Stage 2 Hypertension – systolic: less than or equal to 140 mmHg; diastolic: less than or equal to 90 mmHg. 4. Answer: A. NSAIDs. Quinapril belongs to the class ACE inhibitors. NSAIDs are linked to decreased antihypertensive effects of ACE inhibitors. Allopurinol increases risk of hypersensitivity when combined with ACE inhibitors. 5. Answer: C. Cyanide toxicity. Nitroprusside is metabolized into cyanide. Other manifestations of cyanide toxicity include pink color, loss of consciousness, and absence of reflexes. Recommended ResourcesRecommended resources and reference books. Disclosure: Includes Amazon affiliate links.
See AlsoHere are other nursing pharmacology study guides:
Gastrointestinal System Drugs
Respiratory System Drugs
Endocrine System Drugs
Autonomic Nervous System Drugs
Immune System Drugs
Chemotherapeutic Agents
Reproductive System Drugs
Nervous System Drugs
Cardiovascular System Drugs
References and SourcesReferences and sources for this pharmacology guide for Antihypertensive Agents:
Can nifedipine cause hypotension?Nifedipine is widely used as a tocolytic, since it is well tolerated and inexpensive, nonetheless it should be considered that it can cause severe hypotension.
Does nifedipine cause tachycardia?Nifedipine is a dihydropyridine calcium channel blocker, the short acting formulation of which has been associated with reflex sympathetic nervous system (SNS) activation leading to flushing, tachycardia, worsening myocardial ischemia, and cerebrovascular ischemia; therefore only longer acting formulations should be ...
What is the action of nifedipine?Nifedipine is in a class of medications called calcium-channel blockers. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood and oxygen to the heart.
Is nifedipine a vasodilator?Nifedipine reduces blood pressure predominantly by reducing systemic vascular resistance due to a direct vasodilating action on the arterioles. This peripheral vasodilation appears greater the more severe the hypertension.
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