Cardiovascular and Renal Medications Master Study

Ischemia

Poor blood supply to an organ.

Ischemic heart disease

Poor blood supply to the heart muscle, often caused by conditions like atherosclerosis or coronary artery disease.

Angina Pectoris

Chest pain resulting from insufficient oxygen and nutrients in the blood to meet heart demands.

Chronic stable angina

Also known as classic or effort angina; pain that goes away with rest.

Unstable angina

Also called preinfarction or crescendo angina; occurs more frequently and with a pattern change.

Vasospastic angina

Also known as Prinzmetal or variant angina; pain occurs at rest.

Nitroglycerin

Prototypical nitrate used for symptomatic treatment of ischemic heart conditions.

Nitrates and Nitrites

Medications available in various forms such as sublingual, IV, transdermal, and oral; bypass liver first-pass effect.

Sublingual tablets

Rapid-acting forms of nitrates used to treat acute anginal attacks.

Long-acting nitrates

Used to prevent anginal episodes, available in forms like transdermal patches and ointments.

Tolerance (to Nitroglycerin)

Developed in clients taking nitrates regularly; can be prevented by allowing nitrate-free periods.

Beta₁-adrenergic receptor blocker

Medication class indicated for prophylactic treatment of angina, such as metoprolol.

Calcium Channel Blocker (CCB)

Medication that causes vasodilation and reduces workload on the heart; used for treating angina.

Nursing Implications for Nitrates

Includes health history assessment, monitoring vital signs, and educating clients on medication use.

Sublingual Nitroglycerin

Should not be chewed or swallowed; burning sensation indicates potency.

Heart

The body's powerhouse pump, pushing blood full of oxygen and nutrients to every cell.

Kidneys

The organs that filter blood, get rid of wastes, manage electrolytes, and control water balance.

Blood Pressure (BP)

The force exerted by circulating blood against the walls of blood vessels; high BP can cause damage, low BP can cause organ starvation.

Preload

The amount of blood the heart is stretched with before it contracts.

Afterload

The resistance the heart must overcome to eject blood.

Cardiac Output

The volume of blood the heart pumps per minute, measured as heart rate multiplied by stroke volume.

Electrolytes

Minerals in the body, such as potassium, that affect heart and muscle function.

Vascular Tone

The degree to which blood vessels are constricted or dilated.

Hypertension

Abnormally high blood pressure.

Heart Failure

A condition where the heart is unable to pump effectively.

Coronary Artery Disease

A disease characterized by reduced blood flow to the heart muscle.

Dyslipidemia

An imbalance of lipids (fats) in the blood, commonly high levels of bad cholesterol (LDL) or triglycerides.

Fluid Overload

A condition in which the body has too much fluid, leading to swelling or edema.

ACE Inhibitors

Medications that decrease blood pressure by blocking the conversion of angiotensin I to angiotensin II.

ARBs (Angiotensin Receptor Blockers)

Medications that block the receptors for angiotensin II, leading to blood vessel relaxation and lower blood pressure.

Beta-Blockers

Drugs that reduce heart rate and force of contraction, thereby lowering blood pressure.

Calcium Channel Blockers (CCBs)

Medications that inhibit calcium from entering cells of the heart and blood vessel walls, leading to lower blood pressure and heart rate.

Diuretics

Medications that promote the elimination of water and electrolytes from the body by increasing urine output.

Statins

Medications that lower LDL cholesterol by inhibiting an enzyme involved in cholesterol production.

Nitrates

Medications used to treat angina by dilating blood vessels and increasing blood flow to the heart.

Antihypertensive

Medications used to treat high blood pressure.

Blood Pressure (BP)

Force exerted by blood on the walls of blood vessels.

Compliance

The ability of any compartment to expand to accommodate increased content.

Contractility

The stretch of the muscle fibers, influenced by positive or negative inotropic factors.

Hypertension (HTN)

High blood pressure; characterized by persistent elevated blood pressure readings.

Renin-Angiotensin-Aldosterone System (RAAS)

A hormone system that regulates blood pressure and fluid balance.

Cardiac Output (CO)

The amount of blood the heart pumps per minute.

Systemic Vascular Resistance (SVR)

The resistance to blood flow within the circulatory system.

Primary Hypertension

Hypertension with no identifiable cause, commonly considered essential hypertension.

Secondary Hypertension

Hypertension caused by another medical condition.

Diuretics

First-line antihypertensives that help reduce blood pressure by decreasing plasma volume.

ACE Inhibitors

Medications that block the conversion of Angiotensin I to Angiotensin II, resulting in vasodilation.

Angiotensin II Receptor Blockers (ARBs)

Medications that block the effects of Angiotensin II, leading to vasodilation.

Vasodilators

Drugs that cause the dilation of blood vessels, decreasing blood pressure.

Calcium Channel Blockers (CCB)

Medications that inhibit calcium uptake in heart and smooth muscle, reducing workload.

Hypovolemia

Condition of low blood volume.

Hypervolemia

Condition of excessive blood volume.

Lifestyle Changes for HTN

Weight loss, stress management, supervised exercise, and dietary measures.

JNC-8 Guidelines

2017 guidelines for the classification and management of hypertension.

First-line Antihypertensives

Medications recommended for initial treatment of hypertension.

Adverse Effects of HTN Medications

Dizziness, orthostatic hypotension, fatigue, and toxic effects.

Impotence

A potential side effect of many antihypertensive medications affecting male clients.

Angioedema

Swelling that occurs in the skin, mucosa, and submucosal tissues, which is a serious adverse effect.

A client is diagnosed with poor blood supply to a specific organ. Which of the following terms best describes this condition?

A. Hyperemia
B. Ischemia
C. Thrombosis
D. Embolism

B. Ischemia

A nurse is reviewing a client's chart and notes a diagnosis of poor blood supply to the heart muscle, often linked to atherosclerosis. What term appropriately describes this condition?

A. Myocardial infarction
B. Cardiomyopathy
C. Ischemic heart disease
D. Pericarditis

C. Ischemic heart disease

A client reports chest pain that occurs when the heart's demand for oxygen and nutrients exceeds the supply. The nurse understands this symptom as what?

A. Myocardial infarction
B. Pleurisy
C. Angina Pectoris
D. Indigestion

C. Angina Pectoris

A client experiences chest pain during physical exertion that subsides with rest. The nurse would document this as which type of angina?

A. Unstable angina
B. Vasospastic angina
C. Chronic stable angina
D. Preinfarction angina

C. Chronic stable angina

A client reports chest pain that has become more frequent and severe over the past few days, now occurring even at rest. The nurse recognizes this as a sign of which type of angina?

A. Stable angina
B. Vasospastic angina
C. Effort angina
D. Unstable angina

D. Unstable angina

A client denies chest pain during exertion but frequently wakes up at night experiencing severe chest pain. This presentation is consistent with which type of angina?

A. Chronic stable angina
B. Unstable angina
C. Vasospastic (Prinzmetal) angina
D. Postinfarction angina

C. Vasospastic (Prinzmetal) angina

A nurse is preparing to administer the prototypical nitrate for a client experiencing chest pain due to ischemic heart conditions. Which medication is the nurse likely preparing?

A. Metoprolol
B. Amlodipine
C. Nitroglycerin
D. Digoxin

C. Nitroglycerin

Which characteristic correctly describes nitrates and nitrites used in managing ischemic heart conditions?

A. They are exclusively administered orally.
B. They are primarily metabolized by the liver, undergoing significant first-pass effect.
C. They are available in various forms and can bypass the liver's first-pass effect.
D. They are only used for long-term prophylaxis, not acute attacks.

C. They are available in various forms and can bypass the liver's first-pass effect.

For a client experiencing an acute anginal attack, which form of nitrate is most appropriate for rapid relief?

A. Transdermal patch
B. Oral sustained-release capsule
C. Sublingual tablet
D. IV infusion (unless specified for continuous chest pain)

C. Sublingual tablet

Which of the following nitrate forms is typically prescribed for the prevention of anginal episodes?

A. Intravenous infusion
B. Sublingual tablet
C. Transdermal patch
D. Oral chewing gum

C. Transdermal patch

A nurse is educating a client taking nitrates regularly about potential side effects. What strategy should the nurse recommend to prevent the development of tolerance to nitroglycerin?

A. Taking the medication with food
B. Increasing the dosage over time
C. Allowing for nitrate-free periods
D. Switching to a different class of medication entirely

C. Allowing for nitrate-free periods

A client with angina is prescribed metoprolol for prophylactic treatment. The nurse identifies metoprolol as belonging to which class of medications?

A. Calcium Channel Blockers
B. Nitrates
C. Beta₁-adrenergic receptor blockers
D. ACE Inhibitors

C. Beta₁-adrenergic receptor blockers

A nurse is explaining the action of a prescribed calcium channel blocker to a client with angina. Which effect should the nurse include in the teaching?

A. Increases heart rate and contractility
B. Causes vasoconstriction, increasing blood pressure
C. Causes vasodilation and reduces the heart's workload
D. Only affects the central nervous system

C. Causes vasodilation and reduces the heart's workload

Before administering nitroglycerin, a nurse's primary action should include which of the following?

A. Administering a light meal to prevent gastric upset.
B. Assessing the client's health history and current vital signs.
C. Instructing the client to chew the tablet for faster absorption.
D. Preparing for immediate ambulation to assess efficacy.

B. Assessing the client's health history and current vital signs.

The nurse is providing education to a client about sublingual nitroglycerin. Which statement by the client indicates an understanding of the medication?

A. "I should chew the tablet for quicker absorption."
B. "If I feel a burning sensation under my tongue, it means the medication is working."
C. "I can swallow the tablet with water if I prefer."
D. "I should take this medication daily to prevent angina."

B. "If I feel a burning sensation under my tongue, it means the medication is working."

What is the primary function of the heart in the human body?

A. To filter waste products from the blood.
B. To regulate body temperature.
C. To pump oxygenated blood and nutrients to body cells.
D. To produce hormones essential for growth.

C. To pump oxygenated blood and nutrients to body cells.

Which organs are primarily responsible for filtering blood, managing electrolytes, and controlling water balance in the body?

A. Liver
B. Lungs
C. Kidneys
D. Spleen

C. Kidneys

How is blood pressure best defined?

A. The volume of blood pumped by the heart per minute.
B. The resistance to blood flow in the circulatory system.
C. The force exerted by circulating blood against blood vessel walls.
D. The amount of blood the heart is stretched with before it contracts.

C. The force exerted by circulating blood against blood vessel walls.

A nurse is explaining cardiac physiology. Which term describes the amount of blood that stretches the heart ventricles before contraction?

A. Afterload
B. Stroke volume
C. Preload
D. Cardiac output

C. Preload

What term refers to the resistance that the heart must overcome to pump blood out into the systemic circulation?

A. Preload
B. Contractility
C. Afterload
D. Ejection Fraction

C. Afterload

A nurse is calculating a client's cardiac output. Which formula correctly represents cardiac output?

A. Blood Pressure ÷ Heart Rate
B. Stroke Volume × Heart Rate
C. Preload × Afterload
D. Systemic Vascular Resistance + Blood Pressure

B. Stroke Volume × Heart Rate

Which of the following best describes electrolytes and their function?

A. Proteins that build muscle tissue.
B. Sugars that provide immediate energy.
C. Minerals like potassium that influence heart and muscle function.
D. Fats essential for hormone production.

C. Minerals like potassium that influence heart and muscle function.

What term describes the degree of constriction or dilation of blood vessels?

A. Blood pressure
B. Peripheral resistance
C. Vascular tone
D. Capillary refill

C. Vascular tone

A client consistently presents with abnormally high blood pressure readings. This condition is medically termed as:

A. Hypotension
B. Hypertension
C. Tachycardia
D. Bradycardia

B. Hypertension

A client's diagnosis indicates that their heart is unable to pump blood effectively enough to meet the body's demands. This condition is known as:

A. Myocardial infarction
B. Angina pectoris
C. Heart failure
D. Arrhythmia

C. Heart failure

A client is diagnosed with a condition characterized by reduced blood flow to the heart muscle. Which disease does this describe?

A. Pericarditis
B. Endocarditis
C. Coronary Artery Disease
D. Valvular heart disease

C. Coronary Artery Disease

A client's laboratory results show high levels of LDL cholesterol and triglycerides. This condition signifies an imbalance of lipids in the blood, often referred to as:

A. Hyperglycemia
B. Hypokalemia
C. Dyslipidemia
D. Anemia

C. Dyslipidemia

A nurse notes that a client has significant edema and respiratory crackles. These findings are consistent with which condition?

A. Dehydration
B. Hypovolemia
C. Fluid overload
D. Electrolyte imbalance

C. Fluid overload

A nurse is educating a client about their new ACE inhibitor medication. The nurse should explain that this medication primarily works by:

A. Increasing heart rate and contractility.
B. Blocking calcium channels in the heart.
C. Blocking the conversion of angiotensin I to angiotensin II.
D. Promoting the elimination of water and electrolytes.

C. Blocking the conversion of angiotensin I to angiotensin II.

A client who cannot tolerate ACE inhibitors is prescribed an ARB. The nurse understands that ARBs lower blood pressure by:

A. Inhibiting an enzyme involved in cholesterol production.
B. Directly dilating blood vessels without affecting angiotensin.
C. Blocking the receptors for angiotensin II.
D. Increasing urine output to reduce fluid volume.

C. Blocking the receptors for angiotensin II.

A client is prescribed a beta-blocker for hypertension. The nurse explains that this medication helps lower blood pressure by:

A. Causing vasodilation in the peripheral vasculature.
B. Reducing heart rate and the force of cardiac contraction.
C. Increasing the body's retention of sodium and water.
D. Preventing the absorption of dietary cholesterol.

B. Reducing heart rate and the force of cardiac contraction.

When explaining the action of calcium channel blockers, the nurse should state that these medications:

A. Block potassium channels in cardiac cells.
B. Increase the reabsorption of calcium in the kidneys.
C. Inhibit calcium entry into heart and blood vessel cells, lowering BP and HR.
D. Stimulate sympathetic nervous system activity.

C. Inhibit calcium entry into heart and blood vessel cells, lowering BP and HR.

A client is taking a diuretic for hypertension. The nurse should reinforce that this medication works by:

A. Constricting blood vessels to increase peripheral resistance.
B. Promoting the elimination of water and electrolytes through increased urine output.
C. Directly relaxing the smooth muscles of the heart.
D. Preventing the conversion of angiotensin I to angiotensin II.

B. Promoting the elimination of water and electrolytes through increased urine output.

A client is prescribed a statin medication. The nurse should explain that statins primarily work to lower cholesterol by:

A. Increasing the excretion of bile acids.
B. Inhibiting an enzyme crucial for cholesterol production.
C. Blocking the absorption of fat in the intestines.
D. Enhancing the body's ability to excrete triglycerides.

B. Inhibiting an enzyme crucial for cholesterol production.

Which of the following best describes the primary action of nitrates in treating angina?

A. Increasing myocardial contractility.
B. Dilating blood vessels to increase blood flow to the heart.
C. Reducing the heart's electrical conductivity.
D. Preventing the aggregation of platelets.

B. Dilating blood vessels to increase blood flow to the heart.

A client is prescribed an antihypertensive medication. The nurse understands that the primary purpose of this medication is to:

A. Decrease blood sugar levels.
B. Treat high blood pressure.
C. Relieve pain.
D. Reduce inflammation.

B. Treat high blood pressure.

The nurse is assessing a client's vital signs. What physiological measurement represents the force exerted by blood on the walls of blood vessels?

A. Heart rate
B. Respiratory rate
C. Blood pressure
D. Body temperature

C. Blood pressure

In cardiovascular physiology, which term refers to the ability of a blood vessel or cardiac chamber to expand and accommodate increased volume?

A. Contractility
B. Afterload
C. Compliance
D. Elasticity

C. Compliance

Which term describes the inherent strength and ability of the heart muscle fibers to shorten and pump blood, often influenced by inotropic factors?

A. Preload
B. Afterload
C. Contractility
D. Compliance

C. Contractility

A client is diagnosed with hypertension. The nurse explains that this condition is characterized by:

A. Intermittent drops in blood pressure.
B. Persistent elevated blood pressure readings.
C. Abnormally low heart rate.
D. Fluctuations in blood glucose levels.

B. Persistent elevated blood pressure readings.

A nurse is explaining the body's natural mechanisms for blood pressure regulation. Which hormone system plays a crucial role in regulating blood pressure and fluid balance?

A. Endocrine System
B. Renin-Angiotensin-Aldosterone System (RAAS)
C. Sympathetic Nervous System
D. Parasympathetic Nervous System

B. Renin-Angiotensin-Aldosterone System (RAAS)

What does cardiac output (CO) specifically measure?

A. The pressure in the aorta.
B. The force of ventricular contraction.
C. The volume of blood the heart pumps per minute.
D. The oxygen saturation of arterial blood.

C. The volume of blood the heart pumps per minute.