Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
hypertension
med surg exam 1
| Question | Answer |
|---|---|
| what is the million heart campaign? | hypertension control change package, used to improve hypertension control |
| why is the million hearts campaign important? | every year, americans suffer more than 1.5 million heart attacks and strokes; hypertension increases the risk for heart disease and stroke (two leading causes of death) |
| ABCs of heart health | Aspirin for high risk patients, blood pressure control, cholesterol management, cholesterol management, smoking cessation |
| normal blood pressure | less than 120/ less than 80 |
| elevated blood pressure | 120-129/ less than 80 |
| stage 1 hypertension | 130-139/ 80-89 |
| stage II hypertension | greater than 140/ greater than 90 |
| primary (essential) hypertension idiopathic | no specific cause |
| primary (essential) hypertension incidence | affects nearly half of all adults |
| modifiable risk factors for primary hypertension | diet, salt, alcohol, smoking, etc. |
| non-modifiable risk factors for primary hypertension | genetics, family history, age, race |
| secondary hypertension | results from another disease, side effects of medication |
| examples of diseases that can cause secondary hypertension | diseased kidneys, obstructive sleep apnea |
| examples of medications that can cause secondary hypertension | steroids |
| what can an increase in blood pressure do to arteries? | narrow arteries and eventually lessen blood flow to the heart-> leads to heart failure |
| hypertension affects on the body | heart failure, blurred/ blocked vision, stroke |
| complications of hypertension: end-organ damage | hemorrhage/ stroke, retinopathy, peripheral vascular disease, renal failure/ proteinuria, LVH/ CHD/CHF |
| what does it mean that hypertension is an insidious disease? | people don't know they have it until it gets checked |
| diagnosis of hypertension | blood pressure reading |
| blood pressure reading | patient seated, relaxed, legs uncrossed, back and arm supported; two readings with one-two minute interval between; properly measured (manual BP cuff) |
| first visit taking BP what should you do? | take BP in both arms |
| when taking BP you should average how many readings? | greater than or equal to 2 at greater than or equal to 2 office visits |
| if there is disparity when taking blood pressure, what determines it? | higher value determines |
| white coat syndrome | people experiencing increased blood pressure in exam setting but not in other settings |
| what is white coat syndrome caused by? | anxiety and stress of seeing a healthcare worker in a white lab coat |
| when patient is experiencing elevated bp caused by white coat syndrome what should you do? | wait a few minutes to take their blood pressure |
| hypertension diagnostic tests routine | ECG, CBC, Urinalysis, fasting glucose, potassium, sodium, creatinine, cholesterol, lipid profile, HDL, LDL, and triglycerides |
| diagnosis of secondary hypertension | creatinine clearance, urine albumin, calcium, uric acid, plasma renin activity/ aldosterone measurements |
| lifestyle modifications for hypertension | lose weight, eat fruits and vegetables, reduce salt intake, become active, moderate alcohol intake |
| CDC recommendations for salt intake | no more than 2300 mg per day |
| AHA recommendations for salt intake | less than 1500mg per day |
| DASH diet meaning | dietary approaches to stop HBP |
| DASH diet grains | 7-8 servings/day |
| DASH diet veggies | 4-5 servings/day |
| DASH diet fruits | 4-5 servings/day |
| DASH diet nonfat/low-fat dairy | 2-3 servings/day |
| DASH diet meats, poultry, fish | <2 servings/day |
| DASH diet nuts, seeds, beans | 4-5 servings/week |
| how much should we exercise per week to lower BP? | 10 minutes at a time, 3 times a day, 5 days a week |
| weight reduction modification to lower BP | maintain normal body weight (BMI, 18.5 to 24.9 kg/m2) |
| weight reduction modification approximate systolic BP reduction range | 5-20 mmHg per 10kg weight loss |
| adopting DASH eating plan to lower BP | consume a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated and total fat |
| adopting DASH eating plan approximate systolic BP reduction, range | 8-14 mmHg |
| dietary sodium reduction to lower BP | reduce dietary sodium intake to no more than 100 meq/day (2.4g sodium or 6 g sodium chloride) |
| dietary sodium reduction approximate systolic BP reduction, range | 2 to 8 mmHg |
| physical activity to lower BP | engage in regular aerobic physical activity such as brisk walking (at least 30 minutes per day, most days of the week) |
| physical activity approximate systolic BP reduction, range | 4 to 9 mmHg |
| moderation of alcohol consumption to lower BP | limit consumption to no more than 2 drinks per day in most men and no more than 1 drink per day in women and lighter-weight persons |
| moderation of alcohol consumption approximate systolic BP reduction range | 2 to 4 mmHg |
| BP goals if pt is hypertensive | less than 130/80 |
| first line and later line treatments for hypertension | thiazide-type diuretics, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) |
| stage I hypertension therapy | single antihypertensive drug, blood pressure goal of less than 130/80 |
| stage II hypertension therapy | combination of 2 first line antihypertensive drugs with an average BP more than 20/10 mmHg above the BP target |
| what kind of initial therapy is better for patients of African descent? | thiazide type diuretics or CCB |
| when are ACE inhibitors or ARBs a better choice of drug? | chronic kidney diseases |
| side effect of ACE inhibitors | chronic cough |
| can ACE inhibitors and ARBs be used simultaneously? | no, they work the same |
| what drugs are better choices for hypertension with stable ischemic heart disease? | beta blockers, ACE inhibitors or ARBs as first line drug therapy |
| what drugs are better choices for heart failure with preserved ejection fraction? | diuretics prescribed to control fluid overload; after management of fluid overload, prescribed ACE inhibitors or ARBs and beta blockers to attain SBP of less than 130mmHg |
| what drugs are better choices for heart failure with reduced ejection fraction? | calcium channel blockers not recommended |
| effect of each medication | equal |
| differences in medications | wide variability in response, some drugs work well with patients, some drugs do not- not clear why |
| other things to consider when prescribing medications | cost, concurrent diagnosis, drug interactions |
| hypertension follow up | goal (blood pressure targets), need to monitor Na and K |
| when is it important to monitor a patients electrolytes? | if on thiazide diuretics |
| complimentary therapies for hypertension | yoga, tai chi, mindfulness stress reduction, guided imagery |
| why is there poor treatment adherence? | no symptoms, medication side effects, cost, patient education |
| example of medication side effects | diuretics can make you pee a lot, beta blockers can cause erectile dysfunction |
| malignant hypertension | BP >/= 180/>/= 120 |
| what is malignant hypertension also termed? | hypertensive crisis |
| symptoms of malignant hypertension | blurred vision, headache, confusion; could have no symptoms |
| malignant hypertension requires? | immediate treatment |
| target BP for malignant hypertension | <160/<100 short term |
| in malignant hypertension, mean arterial pressure should not be lowered? | more than 10%-20% first hour, then approximately 25% during the next 23 hours |
| what happens if the mean arterial pressure is lowered too quickly? | it can cause cardiac and cerebral ischemia |
| adverse outcomes of malignant hypertension | cerebral edema, retinal hemorrhage, acute renal damage |
| malignant hypertension causes | unknown, patient abruptly discontinues meds, preeclampsia of pregnancy |
| malignant hypertension therapy | medications immediate actions |
| malignant hypertension medications may include? | nitrates, clonidine, captopril, furosemide |
| what type of patients are furosemide used on? | patients that are fluid overload |
| how often should you monitor BP in malignant hypertension? | q 5-30 minutes |
| other therapy for malignant hypertension | bedrest, quiet environment |
| major exceptions for gradual lowering of BP | acute ischemic stroke, acute aortic dissection, spontaneous hemorrhagic stroke |
| acute ischemic stroke BP lowering | not usually lowered unless >/= 185/110 if patient to receive reperfusion therapy, BP not usually lowered unless >/= 220/120 if patient not to receive reperfusion therapy |
| acute aortic dissection BP lowering | systolic BP rapidly lowered to 100-120 mmHg |
| spontaneous hemorrhagic stroke BP lowering | BP rapidly lowered if no contraindications exist |
Created by:
camrynfoster