Question | Answer |
How to take blood pressure | Taken in seated postition; Use calibrated instrument; seated quietly 5 mins in chair, feet on floor, arm supported at heart level. cuff over 80% of arm. Take 2 b/p readings, tell pt readings. |
Classification of hypertension | Pre-hypertension: 120-139 / 80-89 mm Hg
Stage 1 Hypertension: 140-159 / 90-99 mm Hg
Stage 2 Hypertension: >160 / >100 mm Hg |
Follow up care of hypertension | Normal BP: 2 Years; pre-hypertension: 1 yr; Stage 1 Hypertension: 2 mths; Stage 2 Hypertension: 1 mth; >180/110 mm Hg: Immediate tx. |
What is blood pressure | Pressure exerted by blood on walls of blood vessels; Determined by cardiac output, peripheral vascular resistance, vessel stretch, blood visocosity, blood volume. |
Primary Hypertension | Unknown Cause |
Secondary Hypertension | Known Cause |
Isolated Systolic Hypertension | SBP Over 140 mm Hg |
Hypertension Signs/Symptoms | None "Silent Killer"
Rare - Headache, bloody nose, anxiety, dyspnea |
Target Organ Disease | Damage to blood vessels of heart, kidney, brain, eyes |
Diagnosis of hypertension | History, Signs and symptoms; kidney or heart disease; medications; blood pressure readings. |
Diagnostic Tests | ECG; Blood glucose; hematocrit; potassium; calcium; lipoprotein, cholesterol, triglyceride levels. |
Hypertension risk factors | Nonmodifiable; Family history, age, ethnicity, diabetes mellitus; Modifiable: Weight, diet (sodium, caffeine) Alcohol use, exercise, smoking stress mgmt. |
Hypertensive emergency | SBP > 180 mm Hg Systolic; DBP > 120 mm Hg diastolic; risk for/progression for target organ dysfunction. Gradual reduction of B/P. |
Hypertensive Urgency | Severe b/p elev w/o target organ dysfunction progression. Follow up in several days. Oral meds. |
arterial disease symptoms | Pulse: Diminished, weak, or absent; Skin: Pallor, dependent, rubor, thin, dry, shiny, cool; Edema: Absent or mild; Ulceration: On toes or pres points on feet; Gangrene likely; Pain: claudication, sharp stabbing; Nails: thick, brittle. Hair loss. |
Venous Disease Symptoms | Strong & symmetrical; may be ifficult to palpate because of edema; skin: mottling w/brn pigment at ankles. Edema present; gangrene unlikely; aching cramping, may have nocturnal cramps. Hair and nails normal. |
What to do for arterial problems | Provide a warm environment; cover with warm blankets; dress in warm clothing; avoid extremes of cold and heat. Do not elevate legs. |
What to do for venous problems | Periodic elevation of the lower extremities; well-distrubuted support of the vessels; exercise; avoiding smoking; moderate alcohol & vasodilation; Avoid heating devices. |