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TT2 Hypertension
TT2 NHCC Hypertension
| Question | Answer |
|---|---|
| What is normal blood pressure? | Normal → <120/80 |
| What is the BP range of prehypertension | 120-139/80-89 |
| What is the BP range of hypertension | 140 or > / > 90 |
| What are the two types of hypertension? | Primary and secondary |
| What is primary hypertension? | Hypertension is elevated BP without an identified cause and accounts for 90-95% of all cases of hypertension |
| What is secondary hypertension? | Elevated BP with a specific cause that often can be identified and corrected. This accounts for 5-10% of hypertension in adults and more than 80% hypertension in children |
| What type of hypertension accounts for 90-95% of all cases of hypertension? | primary hypertension |
| What are causes of secondary hypertension? | coarctation or congenital narrowing of the aorta, renal disease such as renal artery stenosis, endocrine disorders, neurologic disorders such as brain tumors, quadriplegia, and head injury, sleep apnea, medications such as sympathetic stimulants, and preg |
| What is Isolated systolic hypertension? | as a sustained elevation is systolic BP equal to or greater than 160 mmHg with diastolic BP less than 90 mmHg. More common in older adults |
| What is white coat hypertension? | Elevated BP readings in clinical setting and normal readings when BP is measured elsewhere |
| What is the definition of hypertension? | – A sustained, elevation of a systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg for extended periods of time. |
| Hypertension causes what changes to blood vessels? | Loss of elasticity in blood vessels – esp. arterioles, Arterioles become sclerotic, tortuous, Fibrin accumulates, damages intima causing edema, clotting, Decreased caliber of arterioles, leading to occlusion |
| What other changes in structures besides the blood vessels does hypertension cause? | ↑ Blood viscosity, pressure, Altered arterioles in organ – esp. brain, hear, kidneys, eyes, Ruptured blood vessels, Damage extends to larger vessels – become sclerosed and tortuous, Enlarged heart |
| What changes in function does hypertension cause? | – Abnormal resistance (due to arteriole narrowing) to blood flow, ↓ Blood flow – esp. to heart, brain, kidneys, lower extremities, Heart failure |
| What subjective history is taken in an assessment for hypertension? | Signs & symptoms, Personal/family history, Lifestyle, Medication history |
| What physical assesment is done for hypertension? | VS, ht, wt, BP accuracy, Inspect & palpate neck, Neuro check, Abdomen, Extremities |
| What are the non-modifiable risk factors of primary hypertension? | Family history, Gender, Age, Culture/Ethnicity |
| What are some modifiable risk factors for primary hypertension? | Stress, Obesity, Nutrition – excess dietary sodium, Smoking, Excessive ETOH intake, Sedentary lifestyle |
| Why is hypertension called the "silent killer" ? | because it is frequently asymptomatic until it becomes severe and target organ disease has occurred. |
| What symptoms arise from the pathologic changes in the heart due to hypertension? | symptoms of CAD such as angina, MI, left ventricular failure, arrhythmia, and sudden death |
| What symptoms arise from cerebralvascular pathologic changes due to hypertension? | transient ischemic attacks possibly leading to stroke |
| What symptoms arise from pathologic changes to the kidneys due to hypertension? | symptoms of renal failure e.g. serum creatinine > or = 1.5 mg/dl proteinuria |
| What symptoms arise from pathologic changes to the eyes due to hypertension? | retinal changes, visual disturbances, hemorrhage, narrowed arterioles papilledema |
| What symptoms arise from pathologic changes to the peripheral vessels due to hypertension? | absence of one or more major pulses in the extremities (except dorsal pedis), intermittent claudication (ischemic muscle pain precipitated by activity and relieved with rest), abdominal aortic aneurysm |
| Name 3 tests that could be used to screen for renal involvement & provide baseline info about kidney function? | Urinalysis, Electrolytes, renal function |
| have a higher incidence of 4 ethnic groups that have a higher incidence of hypertension that whites? | African Americans, Puerto Ricans, Cubans, and Mexican Americans |
| What ethnic group in the US has the highest incidence of hypertension? | African Americans |
| What ethnic group in the US develop hypertension at a younger age than whites? | African Americans |
| What is the prognosis of hypertension in African Amercians? | Hypertension is more aggressive and results in more severe end-organ damage |
| Who has a higher mortality rate from hypertension? | African Americans have a slightly higher mortality rate related to hypertension than whites. |
| African Americans and whites living in what part of the United States have a higher incidence of hypertension than similar ethnic groups living in other parts of the US | southeastern US |
| Which medications do African Americans not respond well to? | angiotensin inhibitors |
| African Americans have less what? | renin |
| What is the goal for the nursing dx Decreased cardiac output? | maintains adequate tissue perfusion |
| What is the goal for the nursing dx High risk for non compliance R/T lack of understanding? | complies with self care program OR remains free of complications |
| How does weight reduction affect hypertension? | Weight reduction has a significant effect on lowering BP in many people and the effect is seen with even moderate weight loss. |
| What does the accronym "DASH" in dash diet stand for? | Dietary Approaches to Stop Hypertension – involves eating several servings of fish each weak, eating plenty of fruits and vegetables, increasing fiber intake, and drinking a lot of water |
| Overall goals for patients with hypertension? | Achieve and maintain the individually determined target BP, Understand, accept, and implement the therapeutic plan, Experience minimal or no unpleasant side effects of therapy, Be confident of ability to manage and cope with this condition |
| What does dietary management of hypertension consist of? | Restriction of sodium, Maintenance of dietary potassium, calcium, and magnesium intake, Caloric restriction if patient is overweight |
| What are the Principles of pharmacology in treating hypertension? | Maximize effect with minimal side effects, May use combination therapy for this, Used for Stage II or III that is not controlled by lifestyle modifications |
| Name 5 classes of drugs used to treat hypertension | a. ACE inhibitors, b. Thiazide Diuretics, c. Angiotensin II Receptor Antagonists, d. Beta adrenergic blocking agents, e. Calcium channel blockers |
Created by:
2007Nurse
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