Open Nephrectomy

Sarah has been taking prazosin for hypertension which a alpha blocker. It blocks receptors in the arteries in smooth muscle. This helps relax the blood vessels and leads to an increase in blood flow and a lower blood pressure. The most common side effects of are dizziness, drowsiness, fatigue, headache, nervousness, irritability, stuffy or runny nose, nausea, pain in the arms and legs, hypotension, and weakness. Also another side effect is first-dose orthostatic hypotension because initially the patient has more sensitive to the blood pressure-lowering effects. As patients continue to take the medication they become less sensitive and have fewer problems with hypotension. There

The algorithm begins with an indication that is used for adults over the age of 18 and noted that lifestyle interventions should be continued throughout management. Goal blood pressures are separated by age and presence of chronic disease. The goal for patients over 60 is SBP < 150 mmHg and DBP < 90 mmHg. The goal for patients under 60 is < 140 mmHg and DBP < 90 mmHg. Different goal values are presented for patients with chronic conditions. Treatment with medication is categorized by: general population nonblack, general population black, chronic conditions black, and chronic condition all races. Based on the algorithm black patients should only be prescribed thiazide type diuretics and/or calcium channel blockers. While non-black patients can take all of the medications listed in JNC 8 (thiazide type diuretics, ACEI, ARB, and/or CCB). If patient does not reach goal blood pressure then three strategies are listed, along with lifestyle adherence. The algorithm also explains not to use ACEI and ARB together. The final option for patients not at goal blood pressure includes additional medications and/or referral to physician with an expertise in hypertension

Usually angiotensin has an effect on the body to increase blood pressure, increase blood volume and increase pressure in the kidney. As the ACE inhibitor lowers the amount of angiotensin, this causes the blood vessels to become wider and there is an increase in the amount of urine produced by the kidneys. The result of this is the blood pressure goes down, blood volume decreases and decreases pressure in the kidneys. The decrease of angiotensin levels by ACE inhibitors also causes a drop in noradrenalin and aldosterone levels, which helps to reduce blood pressure. Another effect ACE inhibitors have is to increase bradykinin which also causes the blood vessels to widen with a further decrease in blood pressure. Examples of ACE inhibitors include; Lisinopril (Prinivil), Captopril (Capoten) and Enalapril

This study was conducted within a six-hospital system, with a total of 856 acute care beds with the main unit a 650-bed level two trauma center. A team was put together from many areas of the hospital: education, urology, hospitalist, and infection control to oversee assessment, interventions, implementation and outcome of the study. Applicable edification was provided for the health-care providers and the protocols, policy and procedures that would have been executed were revised. Multiplicities of pre-cautionary measures were initiated; health-care workers took care

ACE inhibitors such as Captopril block activity of the enzyme ACE and therefore the conversion of angiotensin I to angiotensin II (the most bio active product of the RAAS), thus inhibiting the actions of angiotensin II and leading to decreased aldosterone production, decrease blood volume and reduced hypertension. ACE inhibitors also work to decrease fibroblast activity as a protective measure against remodelling of the left ventricle (19). Side effects of ACE inhibitors include a dry cough due to the inhibition of bradykinin break down, hypotension and hyperkalemia (due to higher levels of potassium reuptake). ACE inhibitors are currently one of the drugs of choice to treat patients with HF.

There is multiple studies about the use of CCB’s in treating Hypertensive emergencies, one study in 1985 shows that CCB’s and specifically the Nicardipine could be used as first line drug in management

Together ACE inhibitors and ARB’s work to lower heart rate and blood pressure by inhibiting the RAS (renin-angiotensin system) in the sympathetic nervous system. This “fight or flight” system is activated by the heart when it senses the inability of the ventricles to pump blood, in which cardiac output and blood pressure are decreased. These medications act by blocking this system and therefore decreasing blood pressure and heart rate (Markaity, 2012). Commonly used ACE inhibitors include: enalapril (Vasotec), benazepril (Lotensin), lisinopril (Prinivil, Zestril) and captopril (Capoten). Commonly used ARBs include: losartan (Cozaar), Candesartan (Atacand), Valsartan (Diovan) (heart.org).Common side effects of ACE inhibitors and ARBs are: dry cough, dizziness, hypotension and hyperkalemia. Renal function tests and serum potassium levels should be monitored periodically. ACE inhibitors and ARBs have a label of pregnancy category D while in the second and third trimesters

The first line choice in patients with heart failure is Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors). ACE inhibitors can help slow progression of heart failure and improve symptoms. ACE inhibitors block the action of a protein (enzyme) that causes blood vessels to narrow. As a result, blood vessels relax and widen. This lowers blood pressure and makes it easier for the heart to pump blood. These medicines also help body release water and sodium, which also helps lower blood pressure. ACE inhibitors relieve heart failure symptoms, such as fluid retention and edema. They may help reduce liver disease and prevent readmission to the hospital. Examples of ACE inhibitors are Captopril, Enalapril, Lisinopril, Quinapril, and Ramipril.

My first objective is the protection of life. I am a combat medic in the Army National Guard, so the protection of life, limb, and eyesight is very important to me. As a combat medic, it is possible for me to be the first one at the scene. First, if it involves trauma, I would stop the bleeding with either a tourniquet or a blood-clotting dressing (NAEMT, 2016). Next, I will check the patient’s airways and breathing. Finally, I would examine them further to determine if they need an intravenous therapy to treat for blood loss, dehydration, or medication. I would follow the remaining steps of the protocol given to me by the physician assistant (NAEMT,

Information to patient: Indicated for hypertension and angina. Reduce the blood pressure and risk of stroke and heart attack. They are calcium channel blockers which works by widening your blood vessels making it easier for your heart to pump blood around the body and help increase blood and oxygen supply to the heart. Taken once daily with or without food at the same time each day. Swallow the tablet whole with a full glass of water. Taking the tablet at the same time each day will have the best effect. It will also help you remember when to take it. You are currently on 5mg but your doctor might increase this depending on how you respond to the medication. Tell your doctor

The study shows that disease-modifying medications were prescribed significantly more often in 2000 than in 1995, particularly in patients younger than 65 and in those aged 75 to 84 (Saczynski et al., 2009, p. 3). The study indicates that Beta-blockers and ACE inhibitors have been shown to improve survival and reduce hospitalizations in patients with Heart Failure. The second article mentioned about the elderly patients who have CHF not on or under dosage of Angiotensin Converting Enzyme (ACE) inhibitors. According to this article ACE inhibitors should be given for patients diagnosed asymptomatic left ventricular systolic dysfunction (LVSD) (EF<40%) and symptomatic heart failure with systolic dysfunction associated with other heart problems such as myocardial infarction, pulmonary hypertension. The suggested dosage for the CHF patients mentioned in the article and due to age-related changes in pharmacokinetic drugs, it also recommended the initial dosage must be half the standard dose and gradual increase after assessing renal function. After studying a group of elderly CHF patients revealed that higher or standard dose of ACE inhibitors reduce the risks of major clinical events. Results from the research display a decrease of hospitalizations due to cardiovascular reason, heart failure, and ischemic events in the standard-dose group. The study also found out that the adverse effects of high doses can be managed by reducing the dosage or by changing

ACE inhibitors are important and useful in the medication and treatment for KH due to their effectiveness in treating hypertension. ACE inhibitors will help treat KH by slowing the angiotensin converting enzyme (ACE). Angiotensin II is produced by the body that can cause vasoconstriction of the blood vessels. Angiotensin II is made from Angiotensin I by the ACE. If the production of Angiotensin II is slowed by the ACE inhibitor, the blood vessels will be able to dilate, and blood pressure is able to be lowered (Copstead and Banasik). Thus, it is important for KH to stay on the ACE inhibitors due to his blood pressure readings. KH’s blood pressure is 135/96. His systolic blood pressure is in the pre-hypertensive range, however, his diastolic blood pressure is in the hypertensive range and therefore, his blood pressure is hypertensive. Since his blood pressure is high, it is important for KH to remain taking the

Imagine this. Sand pelts at your suit and the glass dome that surrounds your head. Wind whips violently all around, and the air is stale. You crack your eyes open to a dry, barren-land with a chill running down your spine, and only one knowledge comes to mind. You are alone. This is how it would feel to step into Mark Watney’s shoes. Told in a comical and thrilling science fiction novel, “The Martian,” by Andy Weir creates a situation in which Mark Watney, the main character, is accidentally left on Mars due to a violent sandstorm, resulting in NASA having to evacuate their mission early without him. Where Mark is thrust in a situation where he must survive, I believe that when thrown into a situation like so, moping only fails you, and perseverance

Mercury is a rocky planet. The surface is heavily cratered like Earth’s moon. Mercury is also covered with boulders and pulverized dust. There is no sign of weather at all, be it clouds or rivers, dust storms or anything. Mercury is geologically dead. Mercury has dorsa, moon-like highlands, montes, planitiae, rupes, and valles. Mercury was heavily bombarded by comets and asteroids. The largest known crater is Caloris Basin with a diameter of 1550km. There are two different types of distinct geographic plains that can be seen on the surface of Mercury. The gently, rolling, hilly plains which are the oldest visible surface on the planet and smooth plains which are widespread flat areas that fill various areas. One feature that is odd would be the rupes, which crisscross the planet’s surface. Rupes are compression folds.

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