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MedSurge-HTN

MedSurge HYPERTENSION review

QuestionAnswer
Secondary HTN differentiated from primary HTN in that primary ... has a specific cause eg. renal disease; can be corrected by medicine/surgery
Cause of primary HTN? no single known cause
Isolated systolic HTN occurs when? systolic BP consistently >140, diastolic BP remains <90
The only type of HTN that does not cause target organ damage is? pseudohypertension
Pseudohypertension is a condition in which? blood pressure measurements are elevated but the blood pressure is actually normal due to thick arteries (elderly)
Symptoms of mild / moderate HTN? asymptomatic "silent killer"
Symptoms of severe HTN? morning occipital head-ache, fatigue, dizziness, palpitations, angina, dyspnea
Elevated BUN and creatinine may indicate? destruction of glomeruli and tubules of kidney resulting in HTN
K+ levels are decreased when HTN is associated with? hyperaldsteronism
Elevated uric acid levels may be caused by? diuretics used to treat HTN
Central adrenergic antagonists, treat HTN by? causing vasodilation by inhibiting sympathetic outflows from the CNS; NOTE: bradycardia
Sprironolactone, treat HTN by? ↓ Na+ and water reabsorption by blocking effects of aldosterone
ACE inhibitors, treat HTN by? interfering with enzyme conversion necessary for production of angiotension II
Thiazide diuretics, treat HTN by? ↓ extracellular fluid volume by ↓ Na+ and water reabsorption in Loop of Henle and distal tubule
B-Adrenergic blockers, treat HTN by? ↓ CO by ↓ rate/strength of heart and ↓ renin secretion by kidneys
Calcium channel blockers, treat HTN by? causing vasodilation of arterioles by blocking movement of calcium into cells
A-Adrenergic blockers, treat HTN by? Blocking peripheral a-adrenergic receptors to cause arteriole and venous dilation; NOTE: orthostatic HTN; change positions slowly
Direct vasodilators, treat HTN by? acting directly on smooth muscles of arterioles to cause vasodilation; NOTE: fluid retention
Pt. teaching for hydrochlorothiazide (HydroDiuril) med? include dietary source of potassium in diet
African Americans produce less _____ and do not respond well to _____ inhibitors. renin, angiotension
Systemic vascular resistance (SVR) is ? the force opposing the movement of blood within the blood vessels
Women with hypertension are more likely to suffer a ____ than an _____. stroke, MI
The net effect of Sympathetic Nervous System is to increase BP by increasing both _____ and _____ cardiac output and systemic vascular resistance
How should initial BP reading be performed? take BP at least 2 times, at least 1 minute apart, record the avg. pressure as the value for the visit
Upon standing the systolic BP _____, while the diastolic BP _____. decreases, increases
Orthostatic Hypertension is defined as what measurements? from supine to standing position - SBP: ↓ 20+ mm Hg / DBP: ↓ 10+ mm Hg / ↑ HR 20+ BPM
Mean arterial pressure (MAP) formula: MAP = (SBP +2DBP) / 3
Initial treatment of hypertensive emergency is to decrease MAP by? no more than 25% within minutes to 1 hour.
Hypertensive emergency develops over what timeline? days to hours
Hypertensive urgency develops over what timeline? days to weeks
In hypertensive emergency, lowering BP too quickly can result in? ↓ cerebral, coronary, or renal perfusion and could participate in stroke, MI or renal failure
The Auscultatory Gap is? a wide gap between the first Korotkoff sound and subsequent beats (usually in older adults)
Created by: fluency