Question

What is different in the actions of ACE inhibitors and beta-blockers with relation to heart failure?

a. The nurse is admitting a patient with hypertension. Upon assessment, the patient’s blood pressure is 180/110 mm Hg.

b. What are the potential complications that can occur with sustained elevated blood pressure?

2. Calculate the daily BMR of a man who weighs 160 lb using the average BMR rate of 1 kcal/kg/hr.

3. Describe the difference between android and gynoid obesity.

4. Define basal metabolism.

Answer 1

1. Beta Blockers Actions:

. Decreased heart Rate

•Decreased rate of conduction

•Decreased myocardial contractility

•Results in decreased workload of the heart which decreases the oxygen demands

ACE inhibitors action :

ACE inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also ↑ plasma renin levels and ↓ aldosterone levels. Net result is systemic vasodilation. Therapeutic Effects: Lowering of blood pressure in hypertensive patients. Improved symptoms in patients with CHF (selected agents only). ↓ development of overt heart failure (enalapril only). Improved survival and ↓ development of overt CHF after MI (selected agents only). ↓ risk of death from cardiovascular causes or MI in patients with stable CAD (perindopril only). ↓ risk of MI, stroke or death from cardiovascular causes in high-risk patients (ramipril only). ↓ progression of diabetic nephropathy (captopril only).

b. Potential Complications of sustained high blood pressure are :-

Damage to your arteries

Aneurysm

Widening/bulging of blood vessel due to weakening of blood vessel wall

Heart failure

Heart muscle thickens difficulty pumping blood

Blocked or ruptured blood vessel in your brain

Weakened and narrowed blood vessels in kidneys

Thickened, narrowed, or torn blood vessels in eyes

3. Android obesity is the obesity in the abdomen, the excess fat in the abdomen. Gynoid obesity is excess fat in the thighs and hips of the lower body.

4. Basal metabolism generates energy to support the body's work on a level we arent even conscious of. Minimum energy expenditure it takes to keep a body at rest alive, so that heartbeat, breathing, temperature maintenance, and other essential functions are maintained