Drug Lisinopril

NURS 1556 Clinical Medications Worksheets Generic Name Lisinopril

Trade Name Prinivil, Zestril

Classification Dose Antihypertensive ACE inhibitors 10 mg

Route

Time/frequency

PO

QD

Peak

Onset

Duration

For IV meds, compatibility with IV drips and /or solutions

6 hr

1 hr

24 hr

N/A

Mechanism of action and indications (Why med ordered) For Hypertension—blocks the conversion of angiotensin I to the vasoconstrictor angiotensin II, increases the plasma renin levels and reduces aldosterone levels. Net result is systemic vasodilation, lowers the blood pressure. For CHF- management—excretion of sodium and water, and retention of potassium.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) On Norvasc- risk for hypotension with concurrent use

Nursing Process- Assessment (Pre-administration assessment) Vital signs before giving Rx. Monitor BP and pulse frequently during initial dose adjustment. Monitor weight and assess lungs for rales/crackles, dyspnea. Assess for peripheral edema, jugular venous distention

Nursing Implications (what to focus on) Contraindications/warnings/interactions- Hypersensitivity; in geriatric: initial dosage reduction due to age-related decline in renal function. Common side effects: CNS: dizziness, drowsiness, fatigue, H/A, insomnia, vertigo, weakness. Resp: cough, dyspnea. CV: hypotension, chest pain, edema, tachycardia. Endo: hyperuricemia. GI: taste disturbances, abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting. GU: proteinuria, renal dysfunction, renal failure. Derm: flushing, pruritis, rashes. F and E: hyperkalemia. Hemat: AGRANULOCYTOSIS. MS: back pain, muscle cramps, myalgia. Misc: ANGIOEDEMA, fever. Lab value alterations caused by medicine: serum K+, BUN, and creatinine may rise, Na+ may decrease. Monitor CBC, may have slight decrease in Hgb and, Hct, leucopenia, and eosinophilia. May increase AST, ALT, alk phos., serum bilirubin, uric acid, and glucose.

Be sure to teach the patient the following about this medication: Take same time daily. Change positions slowly. May cause dizziness. May cause taste impairment that generally resolves in 8-10 weeks. Assessment Evaluation Why would you hold or not give this Check after giving: med? Decrease in BP without BP < 100 systolic or HR < 60 appearance of excessive side Signs of serious adverse effects e.g. effects. Decrease in CHF angioedema. symptoms. Monitor Labs, especially for potassium( normal range 3.55)