| Question |
 |
|
| Answer |
|
|
| BP= |
CO x PR |
| CO= |
HR x SV |
| Hypertension can result from |
change in cardiac output, change in peripheral resistance or both |
| What happens to the BP if the vessels constrict? |
Bp goes up |
| What happens to the BP when the vessels dialate? |
BP goes down |
| Fluid retention and vasoconstriction does what to BP? |
Raises BP |
| What is a normal BP? |
120/80 |
| What is prehypertension BP? |
systolic 120-139, diastolic 80-89 |
| When a pt is in the prehypertension stage what is reccomended to help the pt.? |
Lifestyle changes |
| What is the pt.'s BP if the pt. is in stage 1 Hypertension? |
Systolic 140-159, Diastolic 90-99 |
| What is the pt.'s BP if the pt. is in Stage 2 Hypertension? |
Systolic greater than or equal to 160, diastolic greater than or equal to 100 |
| What % of Adults age 18 and older in the US have normal BP? |
54% |
| What % of adults 18 and older in the US have prehypertension? |
22% |
| What % of adults age 18 and older in the US have Hypertension? |
24% |
| Isolated systolic hypertension is more common in |
older adults |
| What happens as we age that causes increased preipheral resistance? |
decrease in the elasticity of the major blood vessels, which causes increased bp |
| What is Hypertension know as? |
The silent killer |
| When there is an increase in BUN and creatinine what does that tell? |
That the kidneys are being damaged. |
| Alterations in vision or speech, dizziness, weakness, a sudden fall, or temporary paralysis on one side of the body are clinical manifestations of |
CVA or TIAtransient ischemic attack) , Stroke |
| CVA |
cerebrovascular accident |
| Blood volume drops what happens? |
BP drops, Heart Rate increases. |
| What is Peripheral resistance? |
How hard the blood has to pump through the arterials. |
| What could be the outcome of Endothelial dysfunction? |
Damage to the inner layer prevents blood vessels from dialating, causes vasoconstriction, leads to target organ damage. Atherosclerosis, Nitric acid release inhibited. |
| When nitric acid relase is inhibited it causes |
Vasoconstriction |
| Pt.s should not ingest caffeine or smoke cigarettes for at least how many minutes prior to an office visit where their BP will be measured? |
30 minutes |
| A pt. should sit quietly for five minutes with arm at heart level prior to what? |
Having their bp taken. |
| How long should the nurse wait between taking BP if the need arises to take it again? |
Two minutes |
| If protein is found in the urine it indicates damage to what organ? |
The kidneys |
| What is an Echocardiogram |
ultrasound of the heart |
| How do you treat Prehypertention? |
lifestyle changes |
| What is the first med. given to lower blood volume |
Thiazide Diuretics which lowers bp |
| What happens when over diuresis happens? |
BP decreases b/c too dehydrated |
| What are the nursing considerations when giving a diuretic? |
Give early in the day, watch for orthostatic Hypotension, Over diueresis = dehydration. If pt has kidney damage teach to watch for K+ and Na substitutes. |
| What is the difference between the Thiazide and loop diuretics compared to the potassium sparing diueretics? |
Watch for HYPOKalemia in Thiazide and Loop and Watch for HYPERKalemia in potassium sparing |
| If pt. has kidney damage what should the pt. watch? |
Salt subsitutes. |
| What is an adrenegic peripheral agent? |
Reserpine ( Serpasil) |
| What med. can cause constriction, but is supposed to dialate? |
Inderal |
| what is the function of adrenergic agents ? |
ANS controls involuntary functions of the body such as heart rate pupil size and smooth muscle contraction, including in arterial walls |
| What are the side effects of adrenergic agents> |
Orthostatic Hypotention, dizziness, nausea, bradycardia, dry mouth, impotence, bronchoconstriction |
| When giving a pt. beta blockers what should you listen for? |
crackles |
| Beta blocker thearapy can mask what s & s in diabetics? |
Hypoglycemia |
| What meds are usually given in crisis b/c very potent? |
Vasodialators |
| What is a serious side effect of Vasodialators? |
Reflex Tachycardia, be careful watch BP |
| What are Ace inhibitors used to treat? |
hypertension, HR, HFand MI |
| Which drugs usually end in PRIL? |
Ace inhibitors |
| Persistant coughing, postural hypotension and angioedema are side effects of what drugs? |
ACE INHIBITORS ( The Prils) |
| The Angiotension II receptor blockers end in? |
sartan |
| What does the ARB's ( angiotensin II receptor blockers ) do? |
Blocks the action of the angiotnsin II after it is formed |
| What is the function of angiotension II> |
increase BP causes vasoconstriction |
| What is the difference between the ace inhibitors and ARB's? |
ace inhibitors stop angiotension from being formed. ARB's block the angiotension II from binding to the receptors. |
| What is the side effect of ARB's? |
Hypotension |
| What do the nondihydropyridines act on? |
heart and blood vessels |
| What do the Dihydropyridines act on? |
blood vessels only |
| Which calcium channel blocker reduces MI contractility and can worsen HF? |
The nondyhidropyridines because they can affect the heart. |
| What is contraindicated with Calcium channel blockers? |
Grapefruit juice b/c it increase the absorption which causes greater than expected effects from the dose. |
| Do NOT D/C BP meds without Dr.'s order b/c of? |
rebound hypertension |
| What complications would you look for in pt.s with hypertension> |
Check eyes and kidneys |
| What is a hypertensive crisis? |
a hypertensive emergency and urgency |
| What should be done in a hypertensive in a hypertensive EMERGENCY? |
BP must be lowered immediately to prevent target organ damage |
| What should you do in a hypertensive URGENCY? |
Lower the BP within a few hours |
Ch.18 LTI-MA 509
