, What assessments should be made before prescribing any antihypertensive agent? -
CORRECT ANSWERS -• BP (confirmation of elevated BP at three different times), &
head to toe assessment
• LABS: electrolytes (Na and K level; serum Ca); blood glucose and hematocrit; Lipid
profile; Renal function (creatinine and BUN levels); urinalysis, albumin or
albumin/creatinine ratio.
• Assess diet (sodium intake)
• children >3yrs should be assessed @ least once at every visit - preferred method for
children is by auscultation, using a cuff that is appropriate to the child's upper arm.
• 12 lead ekg
• diabetics or those with renal disease should have the albumin/creatinine ratio annually.
Presence of albuminuria, micro albuminuria even in the setting of normal glomerular
filtration rate is associated with increased cardiovascular risk
Why are ACE inhibitors the drug of choice in diabetic patients with hypertension? -
CORRECT ANSWERS -• ACE inhibitors will improve insulin's sensitivity; as well as
reduce the effects of diabetes on the kidneys
• "Protect the Kidney's" - watch for renal function, any creatinine > 2.5 requires dose
reduction!
• Prevents diabetic nephropathy or slow its progression,
• Reduce albuminuria and BP.
• ACE or ARBs should be used to treat the HTN.
• Renal protection; reduces the conversion of AT II and improve the insulin sensitivity
ACE inhibitors are a central part of the treatment of heart failure because they have more
than one action to address the pathological changes in this disorder. Which of the
following pathological changes in heart failure is NOT addressed by ACE inhibitors? -
CORRECT ANSWERS -Activation of the sympathetic nervous system that increases
heart rate and preload.
Heart failure is a leading cause of death and hospitalization in older adults (greater than
65 years old). The drug of choice for this population is: - CORRECT ANSWERS -ACE
inhibitors
ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during
pregnancy is best done by a specialist, which of the following drug classes are considered
to be safe, at least in the later parts of pregnancy? - CORRECT ANSWERS -Beta
blockers
Patients who have angina, regardless of Class, who are also diabetic, should be on: -
CORRECT ANSWERS -ACE inhibitors
Ray has been diagnosed with hypertension and an ACE inhibitor is determined to be
needed. Prior to prescribing this drug, the NP should assess for: - CORRECT ANSWERS
-Decreased renal function
CORRECT ANSWERS -• BP (confirmation of elevated BP at three different times), &
head to toe assessment
• LABS: electrolytes (Na and K level; serum Ca); blood glucose and hematocrit; Lipid
profile; Renal function (creatinine and BUN levels); urinalysis, albumin or
albumin/creatinine ratio.
• Assess diet (sodium intake)
• children >3yrs should be assessed @ least once at every visit - preferred method for
children is by auscultation, using a cuff that is appropriate to the child's upper arm.
• 12 lead ekg
• diabetics or those with renal disease should have the albumin/creatinine ratio annually.
Presence of albuminuria, micro albuminuria even in the setting of normal glomerular
filtration rate is associated with increased cardiovascular risk
Why are ACE inhibitors the drug of choice in diabetic patients with hypertension? -
CORRECT ANSWERS -• ACE inhibitors will improve insulin's sensitivity; as well as
reduce the effects of diabetes on the kidneys
• "Protect the Kidney's" - watch for renal function, any creatinine > 2.5 requires dose
reduction!
• Prevents diabetic nephropathy or slow its progression,
• Reduce albuminuria and BP.
• ACE or ARBs should be used to treat the HTN.
• Renal protection; reduces the conversion of AT II and improve the insulin sensitivity
ACE inhibitors are a central part of the treatment of heart failure because they have more
than one action to address the pathological changes in this disorder. Which of the
following pathological changes in heart failure is NOT addressed by ACE inhibitors? -
CORRECT ANSWERS -Activation of the sympathetic nervous system that increases
heart rate and preload.
Heart failure is a leading cause of death and hospitalization in older adults (greater than
65 years old). The drug of choice for this population is: - CORRECT ANSWERS -ACE
inhibitors
ACE inhibitors are contraindicated in pregnancy. While treatment of heart failure during
pregnancy is best done by a specialist, which of the following drug classes are considered
to be safe, at least in the later parts of pregnancy? - CORRECT ANSWERS -Beta
blockers
Patients who have angina, regardless of Class, who are also diabetic, should be on: -
CORRECT ANSWERS -ACE inhibitors
Ray has been diagnosed with hypertension and an ACE inhibitor is determined to be
needed. Prior to prescribing this drug, the NP should assess for: - CORRECT ANSWERS
-Decreased renal function
