NURS 2516 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Trade Name Classification Dose: 10 mg Route Time/frequency

Name Prinivil ACE Inhibitors Dosage range: 10 mg once daily, can be increased up PO Daily
Lisinopril to 20-40 mg/day (initiate therapy at 5 mg/day in
patients receiving diuretics).
Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
6 hr 1 hr 24 hours N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Angiotensin-converting enzyme (ACE) inhibitors block the pt’s w/ Hypersensitivity and history of angioedema with previous use of
conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors. Use cautiously in pt’s w/ Renal impairment,
ACE inhibitors also prevent the degradation of bradykinin and hypovolemia, hyponatremia, geriatric patients, concurrent diuretic
other vasodilatory prostaglandins. ACE inhibitors also increase therapy (initial dosage reduction recommended). Use extreme caution in
plasma renin levels and reduce aldosterone levels. Net result is pt’s w/ a family history of angioedema.
systemic vasodilation. Indicated for the treatment of hypertention. Common side effects
dizziness, cough,hypotension, n/v/d, rashes, hyperkalemia, and
My patient is receiving this med for Hypertension. angioedema
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) Monitor BUN, creatinine, and electrolyte levels periodically. Serum
Additive hypotension with other antihypertensive agents (Coreg potassium may be increased and BUN and creatinine transiently
for ex.) increased, whereas sodium levels may be decreased. If elevated BUN or
serum creatinine concentrations occur, dosage reduction or withdrawal
may be required. Monitor CBC periodically during therapy in patients
with collagen vascular disease and/or renal disease. May rarely cause
slight decrease in hemoglobin and hematocrit and agranulocytosis. May
cause elevated AST, ALT, alkaline phosphatase, and serum bilirubin.
Be sure to teach the patient the following about this
medication
Instruct patient to take exactly as directed at the same time each day, even
if feeling well. Missed doses should be taken as soon as possible but not
if almost time for next dose. Do not double doses. Warn patient not to
discontinue ACE inhibitor therapy unless directed by health care
professional. Caution patient to avoid salt substitutes containing
potassium or foods containing high levels of potassium or sodium unless
directed by health care professional. Caution patient to change positions
slowly to minimize hypotension, particularly after initial dose. Patients
should also be advised that exercising in hot weather may increase
hypotensive effects. Advise patient to consult health care professional
before taking any OTC medications, especially cold remedies. May cause
dizziness. Caution patient to avoid driving and other activities requiring
alertness until response to medication is known. Instruct patient to notify
health care professional if rash; mouth sores; sore throat; fever; swelling
of hands or feet; irregular heart beat; chest pain; dry cough; hoarseness;
swelling of face, eyes, lips, or tongue; or if difficulty swallowing or
breathing occurs. Persistent dry cough may occur and may not subside
until medication is discontinued. Consult health care professional if
cough becomes bothersome. Also notify health care professional if
nausea, vomiting, or diarrhea occurs and continues. Encourage patient to
comply with additional interventions for hypertension (weight reduction,
low sodium diet, discontinuation of smoking, moderation of alcohol
consumption, regular exercise, and stress management).
Nursing Process- Assessment
(Pre-administration assessment)
Take blood pressure
Assessment
Why would you hold or not give this
med?
If bp is too low contact physician. These
should not be stopped abruptly
Evaluation
Check after giving
Decrease in blood pressure without
appearance of side effects and
improvement in survival and
reduction of symptoms in heart
failure