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H&C Hypertension
H&C Hypertension NUR 235
| Question | Answer |
|---|---|
| What 3 chronic ccomplications are associated with hypertension ? | cardiovascular disease, stroke, chornic kidney disease |
| How should most attempt to reduce hypertenion on their own? | lifestyle changes , diet, exercise smoking, cessation |
| The diagnosis of hypertention in an otherwise healthy 40 year old male may be made when the blood pressure exceeds what ? | 130/80 |
| what demographic has the highest rate of HTN ? | 56% among non-Hispanic Black males 57.6% among non-Hispanic Black females p756 |
| What can be said between the relationship of economic status and blood pressure control ? | adults of higher socioeconomic status have better control of their BPs compared to adults of lower socioeconomic status |
| __________ hypertension is from another cause | secondary |
| What diet habit puts an individual at risk for hypertension ? | eating too much salt, limited intake for veggies, fiber, fish fats and potassium |
| what commonly used analgesic can cause secondary hypertension ? | NSAIDS |
| What behavioral, social and environmental risks factors are there for HTN ? | dietary habits, including limited consumption of vegetables, fiber, fish fats, and potassium and excessive intake of sodium; obesity; poor physical fitness; and excessive alcohol intake |
| what changes in the heart occur as one reaches geriatric age occur and what type of hypertension may be experienced as a result? | atheroclerotic plaque, fragmentation of arterial elastins, collagen deposits, impaired vasodilation, kidney disfunction - Isolated systolic hypertension p757 |
| What are organs (target) are damaged as a result of hypertension if not well controlled ? | retinal, brain, renal, CAD (MI, angina) p757 |
| How is blood pressure diagnosed initially ? | use an average of at least two BP readings on at least two occasions |
| Why is blood pressure in the office often not accurate for diagnosing HTN ? | white coat syndrome - elevated blood pressure due to nerves, anxiety about being in a medical setting |
| A patient has come in to the office and has a BP of 170/110 and it is repeated that day, 168/102 , the MA begins to schedule a follow up to recheck the BP explaining another reading is necessary. What do you the RN tell the patient ? | that no further readings are necessary, the diagnosis of HTN may be made by the provider with two readings same day because they exceed 160/100 |
| What are the instructions for the patient prior to taking a BP? | Avoid eating, smoking, caffeine, physical activity for 30 min before Empty bladder.Sit quietly for 5 minutes .Sit with back supported, with the forearm supported at heart level on firm surface, with both feet on the ground; avoid talking |
| how far apart should BP readings be done when taking more than 1 ? | 1 to 2 minutes p. 759 |
| What is masked hypertension ? | elevated BP outside of healthare settings but normal in office |
| what are you listening for in the neck when assessing a patient with regards to cardiac function ? | carotid bruits |
| what tests to help assess for target organ damage ? | UA, lytes, BUN, Creatinine, cholesterol levels, glucose, ECG |
| Your patient is diagnosed with hypertension and is concerned with costs for medication to treat, what do you tell them ? | many medications are inexpensive, available at low cost , they can compare costs at GoodRx or similar apps |
| When should a patient with a BP of 110/70 with no diagnosis of hypertension, return to the office for a recheck of BP | 1 year |
| When should a patient with a BP of 124/78 with no diagnosis of hypertension return to the office for a recheck of BP ? | 3 to 6 months |
| when should a patient with a BP of 132/ 82 be advised to return to the office for a recheck ? | 1 month |
| How many grams of sodium is advisable for reducing HTN risk ? | 2 gram |
| What high sodium food products have high sodium in them ? | processed foods, deli meats, cheeses, sports drinks, soups, frozen prepared foods |
| Which lifestyle modification has the highest effect on patients with hypertension? | adopting the DASH diet p. 761 |
| How many grains and grain products are in the DASH diet | 6-7 servings DAILY |
| how many fruits and veggies are in the DASH diet | 4 to 5 DAILY EACH ! |
| how many low fat or fat free dairy foods should be consumed in a day in a DASH diet ? | 2 - 3 servings DAILY |
| how much lean fish , meat and poultry in a DASH diet | less than 6 servings DAILY |
| what is the sodium recommendation in the DASH diet ? | 2300 mg total DAILY |
| How many nuts , seeds and dry beans WEEKLY in a DASH diet ? | 4 to 5 servings WEEKLY |
| How many sweets in a DASH diet WEEKLY ? | 5 or less |
| What drug classes are FIRST line for treatment of hypertension ? | thiazide/thiazide type diuretics, ACE, ARBs, CCB |
| A patient has HTN and is taking 3 medications for HTN, regularly. Their BP average is 155/88.What type of hypertension is this considered ? | resistant hypertension p 761 |
| ACE inhibitors end with the suffix __________ | - PRIL (eg. enalapril, lisinopril) |
| ARBS end with the suffix __________ | - sartan (eg. losartan, irbesartan) |
| CCBs didygropyridines end with the suffix _______ | - ipine (eg. amlodipine, nifedipine) |
| CCB - nondihydropyridines , there are two, they are : | diltiazem and verapamil |
| Which first line HTN drug class has a potential to cause gingivitis ? | CCB - nondihyrdopyridines |
| Which first line drug class for HTN is most likely to cause include dry mouth, thirst? | thiazide diuretics |
| Which two first line drug classes for HTN can cause hyperkalemia ? | ACE, ARB |
| second line drugs - Loop diuretics end in what suffix ? | - IDE (eg. bemtanide, furosemide, torsemide) |
| beta blockers - end in what suffix | - OLOL (eg. metroprolol, atenolol) |
| A concern with geriatric patients who are taking blood pressure medications is __________ | orthostatic hypotension , can result in falls, injury |
| Your patient has reported they stopped taking their blood pressure medication two days ago because they did not like the way they made them feel. Their blood pressure is 178/105 today. What phenomena is this ? | rebound hypertension - as as result of abruptly stopping their medication |
Created by:
Kelly Quijano
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