ACE Inhibitors & Arbs (Angiotension II Receptor Blockers)

Explanation
ACE Inhibitors/ARBs often cause a persistent, dry cough. They are often used for heart failure patients - so they would actually DECREASE pulmonary congestion - and they have no effects on nasal congestion or sedative effects.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE Inhibitors/ARBs can cause low white blood cell count, increased potassium level, but have little to no effect on chloride or magnesium.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE inhibitors/ARBs often result in hyperkalemia. They have no effect on sodium, and may cause a transient increase in BUN/Creatinine - but do not cause renal failure.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE inhibitors are often prescribed to reduce the workload of the heart.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
Because ACE inhibitors/ARBs can cause hyperkalemia, potassium-sparing diuretics may make this even worse. Furosemide is not a potassium-sparing diuretic. Protonix has no association with ACE inhibitors/ARBs. Many patients who need ACE inhibitors/ARBs are already on baby aspirin.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
The ACE inhibitors are the "prils"!

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE inhibitors are the "prils"!

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
Patients with heart failure are likely to be put on an ACE inhibitor/ARB. ACE inhibitors/ARBs can CAUSE hypotension. They have no effect on cardiac arrhythmias, and do not directly affect angina.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE inhibitors/ARBs can cause orthostatic hypotension - so patients will need to rise slowly from a sitting position, to avoid falls. ACE inhibitors/ARBs should be taken at the same time of the day everyday - weight should be monitored weekly or biweekly, and leafy green vegetables are contraindicated for meds like Coumadin, since they contain Vitamin K.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE inhibitors/ARBs can cause hypotension. They will not affect respiratory rate or cardiac rhythm. They can reduce white blood cell count, putting the patient at higher risk of infections - but this would not be as immediately important as the blood pressure.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ACE inhibitors/ARBs reduce afterload. Afterload is the pressure the heart has to push AGAINST when it pumps blood out to the body - afterload is higher in high blood pressure, atherosclerosis (clogged blood vessels), and vasoconstriction. Afterload is lower in low blood pressure and vasodilation. Preload is the VOLUME, coming from the body, that enters the heart. Preload is high in fluid volume overload, and low in fluid volume deficit. Most cardiac meds work by either: lowering preload (diuretics) or lowering afterload (vasodilators). ACE inhibitors/ARBs also increase renal blood flow - they shunt more fluid to the kidneys, which reduces the amount of volume going to the heart from the body (reduced preload). Cardiac meds will NEVER increase preload or afterload! That wouldn't be good for the heart!

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
True! Decreased cardiac output is NEVER a good thing.

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.

Explanation
ARBs are the "tans"!

LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-Surgical Nursing: Critical Thinking in Patient Care, 5th ed., San Francisco: Pearson. p.980-981.