ACE Inhibitors (Angiotensin Converting Enzyme) NCLEX Review

This review focuses on ACE Inhibitors, essential cardiac medications used to lower blood pressure by inhibiting the conversion of Angiotensin I to Angiotensin II. Understanding how these drugs work, their side effects, nursing considerations, and patient education is crucial for nursing exams.

Key Points

How ACE Inhibitors Work

• Target: Renin-angiotensin aldosterone system (RAAS)
• Function: Inhibits conversion of Angiotensin I to Angiotensin II, a vasoconstrictor
• Result:
  • Vessel dilation (decreases systemic vascular resistance)
  • Excretion of water and sodium (diuretic effect), retention of potassium (risk for hyperkalemia)

Names and Examples

• Medications end in -pril
  • Examples: Captopril, Lisinopril, Ramipril, Quinapril, Benazepril
• ACE: Angiotensin-Converting Enzyme

Used For

• Heart Failure (systolic dysfunction):
  • Decreases afterload and preload, easier cardiac blood flow
• Hypertension
• Post-Myocardial Infarction: Limits heart damage

Nursing Responsibilities

• Monitor: Blood pressure, pulse, and lab results
  • Labs to Watch:
    • Potassium levels (normal: 3.5-5)
    • Renal function: BUN (5-20), Serum Creatinine (0.6-1.2 mg/dL)
• Observe:
  • Angioedema signs (swelling in the face, difficulty breathing)
  • Patient tolerance to medication (e.g., persistent cough)

Side Effects

• Persistent dry cough
• Dizziness (advise slow position changes)
• Hypotension
• High potassium levels
• Life-threatening angioedema

Patient Education

• Regularly check and record blood pressure and pulse
• Avoid potassium-rich foods and salt substitutes if also on potassium-sparing diuretics
• Persistent cough: Contact the doctor instead of stopping the medication
• Don't skip doses; manage missed doses correctly to avoid complications
• Report symptoms of angioedema immediately

Conclusion

Understanding ACE Inhibitors’ pharmacology, side effects, and nursing implications are vital for effective patient management and successful examination outcomes. Ensure education is provided to patients for safe medication practices.