Pressure Pam — Antihypertensive Classes: Orthostatic Safety and Client Teaching
Every blood pressure pill shares one teaching point — stand up slowly, and never stop it because you feel fine
Her patient feels fine — which is exactly why he stopped taking the pills. Pam's whole job is the teaching that keeps him on them, safely.
Pam keeps the classes straight. Thiazide diuretics are often first-line and waste potassium, so take them in the morning and watch for cramps and weakness. Calcium channel blockers such as amlodipine cause ankle edema, headache and flushing; the non-dihydropyridines slow the heart rate. Beta blockers slow the heart and mask hypoglycemia. ACE inhibitors cause a dry cough and raise potassium; angiotensin receptor blockers do not cause the cough. Every class shares orthostatic hypotension teaching: change position slowly, sit at the edge of the bed before standing, avoid hot baths and alcohol, and never stop the medication abruptly because hypertension is usually symptomless.
Read Pressure Pam's full story →The story arc
The setup
A newly diagnosed client says he has no symptoms and does not see the point of daily pills.
The turn
He starts a thiazide and reports leg cramps and unusual fatigue.
The crisis
He stands up quickly from the chair, goes pale and nearly falls.
The save
Pam sets up a pill organizer, a home cuff and a plan for the dry cough he might get from the new ACE inhibitor.
NCLEX study section — Antihypertensive Classes: Orthostatic Safety and Client Teaching
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Pharmacology
Take this chapter into practice questions on the same topic.