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MS III-HTN
Chapter 37 Workbbook
Question | Answer |
---|---|
Stage 1 Hypertension | Systolic 140-159, or diastolic 90-99 |
Why is Hypertension called the silent killer? | It often has no symptoms and is not discovered until a serious complication develops |
What are some complications of Hypertension? | Heart attack, heart failure, stroke, kidney disease, blindness |
Prehypertension | Systolic 120-139, diastolic 80-89 |
Stage 2 Hypertension | Systolic = or >160 or 1 or >100 |
Isolated pressure elevations | Occassional elevations in B/P and normal readings at other times |
Primary Hypertension | Essential. No known cause, 90-95% of people with Hypertension have this. |
Secondary Hypertension | HTN caused by underlying factors (kidney disease, certain arterial conditions, drugs, pregnancy) |
How do you figure B/P | BP=CO x PVR |
Peripheral vascular resistance | Force in the blood vessels that the left ventricle must overcome to oject blood from the heart |
What are the risk factors for primary HTN? | Dyslipidemia, atherosclerosis, DM, tobacco use, age over 55 for men and 65 for women, family hx, and obesity |
Orthostatic HTN | Sudden change in systolic B/P when changing from a lying or sitting position to a standing position |
Thrombus | Stationary blood clot |
Epistaxis | Nosebleed |
Hypertension | Persistent elevation of arterial B/P of 140/90 Hg or greater |
Syncope | Fainting |
Hypertrophy | Enlargement |
Dyslipidemia | Abnormal amounts of lipids or lipoproteins in the blood |
What are the factors that contribute to HTN | Cardiac stimulation, Rentention of fluid, and vasoconstriction |
What stimulants may contribute to HTN? | Caffeine, Nicotine, and Amphetamines |
Name the symptoms of hypertensive crisis | severe headache, confusion, nausea, restlessness, blurred vision, very elevated diastolic (130 or more) |
Why should you limit sodium with HTN? | Reduces water in the body, decreasing the circulating blood volume |
Why should you exercise when you have HTN? | Decreases blood glucose and cholesterol levels, improves cardiac efficiency by increasing cardiac output and decreasing peripheral vascular resistance |
Why should you quit smoking when you have HTN? | Eliminates vasoconstriction caused by nicotine |
What is the benefit of relaxation or biofeedback when you have HTN? | Reduces stress and lowers B/P |
Why should you lose weight when you have HTN? | Reduces blood pressure by reducing the workload of the heart |
Central adrebergic blockers (action) | Inhibits impulses from the vasomotor center in the brain, reducing peripheral resistance and lowering B/P |
Calcium channel blockers | Block the movement of calcium into cardiac and vascular smooth muscle cells, reducing HR/force of cardiac contraction, adn dilates peripheral blood vessels |
Alpha adrenergic receptor blockers | Block alpha receptor effects, lowering B/P by reducing peripheral resistance |
ACE Inhibitors | Prevents the conversion of Angiotension I to Angiontensin II. Decreases peripheral resitance. Decreases fluid retention by decreasing the production of aldosterone |
Direct vasodilators | Relax arteriolar smooth muscle |
Beta adrenergic receptor blockers | Reduces B/P by clocking the beta effects of catecholamines |
Diuretics | Reduces blood volume through promotion of renal excretion of sodium and water |
Angiotension II receptor antagonists | Blocks receptors for angiotension II and reduce aldosterone secretion |
Common side effects of centrally acting drugs | dry mouth, weakness, drowsiness |
Common side effects of Beta blcokers | Hypoglycemia, Bradycardia, fatigue |
Common side effects of Calcium channel blockers | Flushing, dizziness, and headache |
Common side effects of Alpha adrengeric blockers | Palpitations, dizziness, headache, drowsiness, reflex tachycardia |
Common side effects of Diuretics | Hypovolemia, hypokalemia, hyponatremia |
Common side effects of ACE Inhibitors | skin rash, cough, neutropenia |
What are the four body structures that is damaged by long-term HTN | Brain, Eyes, Heart and Kidneys |
What are the long-term effects of HTN on the eyes? | Retinal hemorrhages, narrowing of retinal arterioles, and Papilledema |
Papilledema | Edema of the optic nerve |
What are the long-term effects of HTN on the heart? | Angina, CHF, and MI |
What are the long-term effects of HTN on the kidneys? | Chronic renal failure, due to narrowing of the renal arteries |
What are the long-term effects of HTN on the brain? | TIA, CVA |
At waht age do complications of HTN increase? | 50 years |
What is the leading cause of death in people with HTN? | Cardiac disease |
What effects does aging have on the body? | Decreased elasticity of arteries, decreased CO, increased peripheral vascular resistance, increased systolic B/P, pulse pressure widens |
The most common cardiovascular problem in the US today is: | HTN |
The cause for primary HTN: | Unknown |
Hypertension is usually detected in which age group? | 30-50 |
Isolated systolic B/P elevations of 160 mm in older adults are most often due to: | atherosclerosis |
The diameter of blood vessels is regulated primarily by: | Thryroid gland hormones |
Beta blockers are contraindicated in patients with: | Asthma, COPD, heart block, or CHF |
Which group of patients responds better to diuretics as treatment for HTN? | African Americans |
When people with diabetes are taking Beta blockers for HTN, the only sign of hypoglycemia may be: | Diaphoresis |
Older patients taking beta blockers are at greater risk than younger people for: | bradycardia |
When body position is changed from supine to standing, the pressure normally: | Systolic falls approx. 10 and diastolic rises approx. 5 |
If a patient's diastolic pressure reaches 120 mm, the nurse should: | Contact dr |
What is the danger of suddenly stopping an antihypertensive drug? | Rebound HTN |
People with HTN should not take what OTC product: | Cold rememdies, b/c they most often contact vasoconstriction properties |
Without treatment, the patient experiencing a Hypertensive crisis may: | Have a stroke |
A common side effect of all antihypertensives is: | Sexual dysfunction |
What percentage of people with HTN do not even realize they have it? | 30% |
How does a small blood pressure cuff affect the reading | False high reading |
Which food group should be increased with DASH approach? | Veges, fruits, nuts/seeds, whole grains, pultry, fish, protein, fiber, potassium, calcium, magnesium |
Which blood studies are usually ordered with people who have HTN? | Hct, glucose, k+, ca, creatine, lipid profile |
Teaching points for people who have orthostatic HTN: | Avoid prolonged standing, avoid hot baths and showers, rise slowly |