A patient with a recent onset of nephrosclerosis has been taking an ACE inhibitor and a thiazide diuretic
The patient's initial blood pressure was 148/100 mm Hg. After 1 month of drug therapy, the patient's blood pressure is 130/90 mm Hg. The nurse will contact the provider to discuss:
a. adding a calcium channel blocker to this patient's drug regimen.
b. lowering doses of the antihypertensive medications.
c. ordering a high potassium diet.
d. adding spironolactone to the drug regimen.
ANS: A
In patients with renal disease, the goal of antihypertensive therapy is to lower the blood pressure to 130/80 mm Hg or less. Adding a third medication is often indicated. Lowering the dose of the medications is not indicated because the patient's blood pressure is not in the target range. Adding potassium to the diet and using a potassium-sparing diuretic are contraindicated.
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