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MedSurge-HTN
MedSurge HYPERTENSION review
| Question | Answer |
|---|---|
| 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) |
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