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Hypertension
PN 141 test 1 book: med surg nursing pg:669
| Question | Answer |
|---|---|
| Def of HTN | SBP more than 140, DBP more than 90, on 3 separate readings several weeks apart |
| What 7 different categories of meds are used to control HTN | Diuretics, Beta blockers, Sympatholytics, vasodilators, ACE inhibitors, angiothsin II receptors, calcium channel blockers |
| What three meds decrease circulating blood volume | Diuretics, ACE inhibitors, Angio-tensin II receptor Blockers |
| What antihypertensive med works best? | No one primary anti-Hypertensive drug is used in Tx of high BP but a combo of meds is used |
| Anti-hypertensive meds that are most effective in African Americans | Diuretics, Calcium channel blockers |
| Anti-hypertensive meds that are most effective in treated the elderly | Diuretics |
| What pt needs a more aggresive Tx of HTN; why? | Pt w/ CHD, to decrease the risk for MI, heart failure, stroke |
| What is the Definition of secondary HTN? | Elevated BP that is related to a disorder |
| What percent of all HTN is Secondary HTN | 5% |
| What is the number one cause of secondary HTN; why? | Kidney disease; b/c it disrupts regulation of renin-angiotensin aldosterone system & can increase salt and water retension |
| What are some other causes of secondary HTN, besides kidney failure | preg, stimulant drug, endocrine, neuro disorders |
| What 2 tests are done to confirm secondary HTN | blood chem, UA |
| How should BP be measured to assess properly for HTN | after resting 5 min, avoid caffeine and smoking for 30 min |
| What is the main Tx of HTN? | To lower BP to norms, to decrease risk to CV system and other organs |
| Can HTN be cured? | NO |
| How can HTN be controlled? | By meds and lifestyle changes |
| What diet should be instituted for a pt w/ HTN? | Decreased in sodium & fat, promote wt loss, increase potassium |
| Diet: What does DASH stand for in the DASH diet | Dietary Approach to stop HTN |
| Diet: What does the DASH diet consist of | Whole grains (7-8 servings), veg (4-5), fruit (4-5), lean meats, low fat milk (2-3, calorie limit of 2,000/ day |
| Why is smoking a risk factor for HTN? | constrict BV, & increase PV resistence, and it can decrease the benefits of anti-hypertensive meds |
| How does physical activity help decrease BP? | Regular exercise decreases BP, and contributes to wt loss |
| How does stress increase BP? | it increases BV constriction and BP |
| What age is most affected with HTN? | more than 50 years old |
| What percentage of people more than 80 years old have HTN | 71% |
| What ethnicity is more of a risk factor for HTN | African Americans |
| Why is HTN called the "silent killer" | b/c it has very few s/s |
| Persistent elevated BP can lead to what 3 serious disorders | brain attack (stroke), CHD, Chronic renal failure |
| The def of a hypertensive crisis | It is a rapid increase SBP more than 240, or DBP more than 130 |
| In a hypertensive crisis why is immediate Tx, w/in 1 hr, important? | to prevent irreversable damage to the heart |
| S/s of a hypertensive crisis | HA, confusion, blurred vision, restlessness, motor and sensory deficits |
| Nursing care for Hypertensive crisis | monitor BP q 5-30 min |
| What complications occur from uncontrolled HTN to the eyes | Retinopathy (narrowed BV, hemmorrages, fluid leakage, swelling of optic nerve) |
| What complications occur from uncontrolled HTN to the heart | CHD, angina, MI, L ventricle Hypertrophy, Heart failure, Dysrhythmias |
| What complications occur from uncontrolled HTN to the vascular system | PVD, Aneurysms |
| What complications occur from uncontrolled HTN to the Kindeys | Renal insufficiency, renal failure |
| What s/s may a pt w/ uncontrolled HTN complain of? | HA, dizziness |
| When will s/s develop with htn? | When htn is advanced |
| What are the advanced s/s of HTN | Morning Head ache, blurred vision, unsteadiness, depression, nocturia |
| What is the normal BP | 120/80 |
| HTN classification: Pre- hypertension BP | 120-139/ 80-89 |
| HTN classification: Stage 1 BP | 140-159/ 90-99 |
| HTN classification: Stage 2 BP | more than 160/ more than 100 |
| How is HTN classified | By cause and course |
| What is the primary cause of HTN? | primary cause is unknown |
| What are the risk factors for HTN that can be changed | Mineral intake (high sodium diet, low potassium. calcium, and magnesium diet), obesity, Insulin resistance, excess alcohol consumption, smoking, phys. or emotional stress |
| What are the risk factors for HTN that can not be changed | family history, age, race |
| what is the primary factor that determines what a pt BP will be | Peripheral vascular resistance |
| What happens to the blood flow in HTN | the resistance of blood flow is increased because of the constriction of arterioles |
| What does a sustained increase in BP increase the rate of? | Atherosclerosis |
| What does a sustained increase in BP increase the risk for | Stroke |
| Mechanisms that regulate BP are (4 things) | overactivity of SNS, overactivity of renin-angiotensin aldosterone system, chemical mediators, insulin resistance |
| How does the overactivity of the CNS effect BP | it vasoconstricts and increases cardiac output |
| How does the overactivity of the renin-angiotensin aldosterone system affect the BP | it vasoconstricts, effects the excretion of sodium and water, can cause permenant damage to arterioles |
| How does chemical mediators effect BP | affects salt and water excretion, and affects the BV constriction |
| How does insulin resistance affect BP | it decreases the effects of vasodilation substances, affects kidney function and increases sns activity |
| What happens to the left ventricle because of an increased BP (2 things) | The workload of it increases, and left venticle muscle mass increases |
| changes in BP with the older adult happen why? | b/c Blood vessels become more rigid and the ability of them to expand and contract decrease so peripheral vascular resistance increases |
| Def of myocarditis | Inflammation of the heart muscle |
| Def of Blood Pressure | The force exerted by blood against the walls of the blood vessels |
| Def of pericarditis | Inflammation of the pericardium (sac/ outer most layer of the heart) |
| For what antihypertensive med is the mechanism of action unknown for the decrease of blood pressure; what is the action thought to be | Dieretics, thought to be based on the ability to increase excretion of sodium from body |
| Meds: What does an ACE Inhibitor do | They suppress the renin angiotensin aldosterone system and prohibit the activity of ACE (Ace is the conversion of angiotensin 1 to 2 a powerful vasocontricter) because of this sodium and water are not retained and BP decreases |
| What is ACE? | the convertion of angiotensin 1 to 2 |
| What is a common side effect of ACE inhibitors | Coughing |
| MEd: Should doses of Ace inhibitors be skipped? Why or why not | no, because a skipped dose can increase BP significantly |
| Med: What do Beta blockers end in | LOL |
| MEd: What do calcium channel blockers end in? | pine |
| Med: What do Ace inhibitors | Pril |
| Med: What is the action of a vasodilator | it decreases the BP by relaxing the vascular smooth muscle and decreasing peripheral vascular resistance |
| Med: Nursing considerations for Vasodilators | give w/ meals, assess BP, monitor BMs |
| Med: What is the Action of Calcium channel blockers | it inhibits the movement of calcium ions across cell membranes of cardiac & arterial smooth muscle cells which results in less calcium available for transmission of nerve impulses, It relaxes BV and increases the supply of oxygen to heart (decreases heart |
| What two antihypertensive meds decrease the pulse of the pt | Calcium channel blockers and beta blockers |
| Med: What is a GI side effect of calcium channel blockers? | Constipation |
| MEd: Angiotensin II recepter Antagonist action | Block binding of angiotensin II various recepter sites in vascular smooth muscle, which block vasoconstriction on effect of renin angiotensin, thus decreases BP |
| Med: Nursing considerations for Med: angiotensin II recepter Antagonist action are the same as what classifications | Ace inhibitors |
| Med: Action of beta blockers | They block the sympathetic input to the heart which decreases the heart rate and cardiac out, also interferes with the renin-angiotensin system thus blocking vasocontriction |
| Med: Nursing care for Beta blockers | so not stop abruptly, do not give to pt w/ COPD and asthma, Can block hypoglycemia s/s |
| Med: What pt should not take Beta Blockers | Pt with COPD, Asthma |
| med- ACE inhibitors: Why do you want to give them one hour before meals | to increase absorption |
| MEd: what antihypertensive can block hypoglycemia s/s | Beta blockers |
Created by:
jmkettel
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