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Stack #175161
HCC 2008 Hypertension
| Question | Answer |
|---|---|
| High Blood pressure is a sign, risk factor for | CVD or a disease |
| to diagnose High Blood Pressure/hypertension the patient must have had | an average of to or more BP readings in 2 or more contacts with a HCP after initial screening |
| Normal average BP is | a SBP <120 and DBP <80 |
| Pre-hypertension BP is | SBP 120-139 or DBP 89-89 |
| Stage 1 hypertension BP is | SBP 140-159 or DBP 90-99 |
| Stage 2 Hypertension BP is | SBP >160 and DBP >100 |
| BP= | cardiac output x systemic vascular resistance |
| the regulation of BP involves | the sympathetic nervous system, renin-angiotensin-aldosterone system, and vascular endothelium |
| what is the difference btw primary and secondary hypertension? | primary: reason is unknown, secondary: associated with a specific cause |
| what are some causes of secondary hypertension? | renal disease, endocrine disorders, brain tumore, pregnancy, kidney tumore, BC pills |
| isolated systolic hypertension is a SBP>_______.....with a DBP below_____ | 140,90 |
| isolated systolic hypertension increases with age r/t | |
| what factors contribute to the development of hypertension? | age(>40-50), excess alcohol, cigarette smoke,diabetes, elevated serum lipid levels, excess dietary sodium, gender, family history, obesity, stress, ethnicity, insulin resistance, secondary lifestyle, socioeconomic status |
| how does a person know they have hypertension? | |
| hypertension increases cardiac workload and causes thickening and sclerosis of arterial walls leading to ___________ __________ | ventricular hypertrophy |
| arterial lumen decrease leads to _____________ blood supply to tissues, __________ and rupture with sustained elevated pressure | decreased, thrombosis |
| some CV clinical manifestations | SOB, chest pain, epistaxis, fatigue, s4 heart sound |
| some Neuro clinical manifestations | dizziness, headache, blurred vision, alteration in speech and balance, TIA or stroke |
| some Renal clinical manifestations | nocturia, increased BUN and creatinine |
| some EYE clinical manifestations | retinal changes: arteriolar narrowing, hemorrhages, papilledema (usualy the first sign bc you can see the vessels) |
| How/when should a BP be taken? | rest for 5 minutes before, no smoking or caffine for 30 mins before, taken in both arms |
| average of _____ readings taken ____ minutes apart | two, two |
| what is white coat hypertension | pt is scared of the doctor or health care provider and BP rises bc of anxiety |
| pulse pressure | determined by stroke volume and elasticity of arteries (difference btw systolic and diastolic) |
| normal pulse pressure | 30-40 mm Hg |
| pulse pressure increases with | atherosclerosis and hypertension |
| Mean arterial pressure (MAP) | average pressure at which blood moves through the vasculature |
| MAP should exceed __________ for adequate tissue and organ perfusion | 70-80 mmHg |
| MAP= | (SBP + 2(DBP))/3 |
| MAP is done when someone is very _____ | ill |
| orthostatic Bp readings | record P and BP in lying sitting and standing positions |
| normal postural changes include | increase pulse 5-20bpm above normal resting rate, unchanged SBP or slight decrease if 10 mmHG, slight increase of 5 mmHG in DBP |
| what is the lab data/test metabolic panel performed? | broad screening tool |
| what is the lab data/test CBC performed? | check for infection and hemoglobin |
| what is the lab data/test Lipid profile performed? | cholesterol |
| what is the lab data/test ECG/Echocardiogram performed? | check heart and cardiac enlargement |
| what is the goal for treatment of hypertension? | prevent death and complications by acheiving and maintaing BP<140/90; 130/85 for diabetics |
| treatment determined by... | BP, presence of CV disease, TOD and risk factors |
| treatment also includes | Lifestyle modifications and drug therapy |
| Lifestyle modifications include | weight reductions, DASH diest , sodium reductions and aerobic physical activity, moderation of alcohol consumption, drug therapy |
| weight reduction means | lose weight if overweight, aim for BMI between 18.5-24.5 kg/m2 |
| dash diet includes | normal diet with reduced Na intake, moderate alcohol intake, and overall eating healthy |
| Ruduce sodium to... | 204g/day = 1 tsp = no added salt in cooking or on the table |
| aerobic activity means | 30minutes/day most days; medical clearance and activity prescribed before exercise |
| moderate alcohol consumption means limit to | 2 drinks/day for men, 1 drink/day for women |
| two main actions of drug therapy | reduce systemic vascular resistance(SVR), decrease circulation blood volume |
| Alpha 1&2 location of receptors and SNS response | blood vessels; vasoconstriction |
| Beta 1 location of receptors and SNS response | heart and kidneys; increases heart rate, contractility and speed of contraction; increases renin release |
| Beta 2 location of receptors and SNS response | bronchioles; bronchodilation |
| adrenergic inhibitors | block the SNS response at different receptor sites, prevent vasoconstricting |
| initial drug therapy is | thiazide diuretics |
| drug selection depends on | |
| ACE inhibitors/ARBs are beneficial for | |
| Beta-blockers are beneficial for clients with | angina and MI |
| most clients require ___ medications | 2 |
| __________ ________________ is a common adverse affect because it lowers BP | orthostatic hypotension |
| why shouldn't Antihypertensive medications be stopped abruptly? | hypertensive crisis |
| nursing interventions for hypertension include | teach & motivate pt to adhere treatment regimen and implement lifestyle changes, medication teaching & monitoring, regular follow-up to monitor progress & identify & treat complication of disease or therapy, encourage weight loss goal, assess nutrition |
| _____% of patients stop taking med within a year | 50 |
| Nursing interventions for non compliance | individualize plan of care that is compatible with pts lifestyle, use combo drugs, encourage family support, home BP monitoring reinforces need for therapy |
| Causes of Hypertensive crisis | HTN poorly controlled; nonadherence to drug therapy, abrupt discontinuation of antihypertensive medication, cerebral hemorrhage, renal disease, aortic aneurysm |
| Hypertensive emergency | hours to days, DBP>120mmHg with evidence of TOD, BP must be lowered immediately to halt or prevent target organ damage |
| S/S of hypertensive emergency | sever headache, N&V, confusion, blurred vision, seizeres, coma |
| management of hypertensive emergencies | ICU, arterial ine for continuous BP monitoriing, IV meds: Nipride, nitroglycerin |
| nursing priority in a hypertensive emergency | stabilizing BP, medication administration, monitoring patient status |
| Hypertensive URGENCY | have a little more time, BP must be lowered withina few hours, maaged with fast acting oral meds (Catapres(chonidine)); BP is elevated but there is not organ damage |
Created by:
jaed008
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