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Hypertension & Medications

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Hypertension- the consistent elevation of arterial blood pressure. Chronic HTN is a sustained systolic blood pressure of greater than 140 mmHg or diastolic pressure of greater than 90-99 mmHg after multiple measurements are made over several clinical visits.

Basic Patho
Disease of the vascular regulatory system in which the mechanisms that usually control arterial pressure within a certain (normal) range are altered.

Medications
1. chlorothiazide (Diuril)- Acts on distal tubule and thick ascending limb of the loop of Henle by increasing excretion of water, sodium, chloride, potassium, magnesium.
Common Side Effects- headache, dizziness, fatigue, orthostatic hypotension, hypokalemia, N/V, anorexia, constipation, urinary frequency, photosensitivity.
Nursing Considerations- BP lying, standing; postural hypotension may occur, especially in geriatric pts. Electrolytes: sodium, potassium, chloride, calcium, magnesium; include BUN, blood glucose, CBC, serum creatinine, blood pH, ABGs, uric acid; glucose in urine if patient is diabetic.

2. hydrochlorothiazide (Microzide)- Acts on distal tubule and ascending limb of loop of Henle by increasing excretion of water, sodium, chloride, potassium.
Common Side Effects- dizziness, fatigue, weakness, orthostatic hypotension, hypokalemia, N/V, anorexia, urinary frequency, hyperglycemia, hyperuricemia.
Nursing Considerations- BP lying, standing; postural hypotension may occur, especially in geriatric pts. Signs of metabolic alkalosis: drowsiness, restlessness. Signs of hypokalemia: postural hypotension, malaise, fatigue, tachycardia, leg cramps, weakness, dehydration.

3. enalapril (Vasotec)- Selectively suppresses reninangiontensin-aldosterone system; inhibits ACE; prevents conversion of angiotensin I to angiotensin II, dilation of arterial, venous vessels.
Common Side Effects- insomnia, dizziness,

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