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Case Study

c. Enalapril is an ACE inhibitor that can cause hyperkalemia (a high potassium level).
b. Furosemide is a loop diuretic and is used to decrease fluid volume.

Review Questions

d. Cardiac output is composed of heart rate × stroke volume. Normal resting cardiac output is 4–5 liters per minute.
d. Lisinopril inhibits the enzyme that converts angiotensin I to angiotensin II.
c. 7.5 m g ÷ 2.5 m g = 3 t a b l e t s .
c. Sacubitril inhibits neprilysin, which is an enzyme that breaks down BNP. BNP stimulates vasodilation and sodium and water excretion, which decrease afterload and preload, respectively.
a. Valsartan and spironolactone can cause potassium to be reabsorbed in the nephron. Clients are at risk for hyperkalemia.
c. Dapagliflozin is a sodium-glucose cotransporter 2 inhibitor and has received FDA approval for use in the treatment of heart failure.
c. 60 m g ÷ 40 m g = 1.5 o r 1 1 2 t a b l e t s .
c. Research has shown that beta blockers and medications affecting the RAAS do not work as well in the treatment of heart failure for Black clients as hydralazine and isosorbide dinitrate do.
d. Digoxin is a cardiac glycoside and slows the heart rate. It can cause bradycardia. The health care provider should be notified before administering this drug.
b. Ivabradine is an I(f) current inhibitor. Grapefruit juice increases blood levels of ivabradine by inhibiting its metabolism. The excess amount of medication can intensify the medication’s hypotensive effect, placing the client at an increased risk for syncopal episodes.

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