Angiotensin Inhibitors Angiotensin-Converting Enzyme Inhibitors Benazepril (Lotensin) Captopril Enalapril (Vasotec) Fosinopril Lisinopril (Zestril) Moexipril (Univasc) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Inhibit ACE,

Adrenergic Inhibitors Central-Acting α-Adrenergic Agonist Clonidine (Catapres) Clonidine patch (Catapres-TTS) Reduce sympathetic outflow from CNS. Reduce peripheral sympathetic tone, produces vasodilation, and decreases SVR and

Drug Examples Mechanism of Actions Nursing considerations Diuretics Thiazide and Related Diuretics Chlorothiazide (Diuril) Chlorthalidone Hydrochlorothiazide Indapamide Metolazone (Zaroxolyn) Inhibit NaCl reabsorption in the distal

Lifestyle modifications Weight reduction Weight loss of 22 lb (10 kg ) may decrease SBP by approx. 5 to 20 mm Hg Calorie restriction and

Diagnostic studies Diagnostic assessment History and physical examination, including an ophthalmic examination Routine urinalysis Basic metabolic panel (serum glucose, sodium, potassium, chloride, carbon dioxide, BUN,

Complications Target organ diseases occur most frequently in Heart Hypertensive heart disease Coronary Artery disease Hypertension disrupts the coronary artery endothelium This results in a

Pneumonia Acute infection of lung parenchyma Associated with significant morbidity and mortality rates Pneumonia and influenza are 8th leading cause of death in the U.S.

Nursing diagnoses Ineffective airway clearance related to bronchospasm, excessive mucus production, tenacious secretions, and fatigue Anxiety related to difficulty breathing, perceived or actual loss of

Nursing management  Health promotion Teach patient to identify and avoid known triggers Use dust covers Use scarves or masks for cold air Avoid aspirin and

Drug therapy Three types of anti-inflammatory drugs Corticosteroids (e.g., beclomethasone, budesonide) Suppress inflammatory response Reduce bronchial hyper-responsiveness Decrease mucous production Inhaled form is used in

Interprofessional care The current guidelines focus on Assessing the severity of the disease at diagnosis and initial treatment and then Monitoring periodically to control the

Diagnostic studies Detailed history and physical exam Spirometry Peak expiratory flow rate (PEFR) Chest x-ray Oximetry Allergy testing Blood levels of eosinophils Diagnostic Assessment History