MedSurge HYPERTENSION review
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Secondary HTN differentiated from primary HTN in that primary ... | has a specific cause eg. renal disease; can be corrected by medicine/surgery
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| Cause of primary HTN? | no single known cause
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| Isolated systolic HTN occurs when? | systolic BP consistently >140, diastolic BP remains <90
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| The only type of HTN that does not cause target organ damage is? | pseudohypertension
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| Pseudohypertension is a condition in which? | blood pressure measurements are elevated but the blood pressure is actually normal due to thick arteries (elderly)
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| Symptoms of mild / moderate HTN? | asymptomatic "silent killer"
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| Symptoms of severe HTN? | morning occipital head-ache, fatigue, dizziness, palpitations, angina, dyspnea
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| Elevated BUN and creatinine may indicate? | destruction of glomeruli and tubules of kidney resulting in HTN
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| K+ levels are decreased when HTN is associated with? | hyperaldsteronism
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| Elevated uric acid levels may be caused by? | diuretics used to treat HTN
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| Central adrenergic antagonists, treat HTN by? | causing vasodilation by inhibiting sympathetic outflows from the CNS; NOTE: bradycardia
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| Sprironolactone, treat HTN by? | ↓ Na+ and water reabsorption by blocking effects of aldosterone
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| ACE inhibitors, treat HTN by? | interfering with enzyme conversion necessary for production of angiotension II
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| Thiazide diuretics, treat HTN by? | ↓ extracellular fluid volume by ↓ Na+ and water reabsorption in Loop of Henle and distal tubule
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| B-Adrenergic blockers, treat HTN by? | ↓ CO by ↓ rate/strength of heart and ↓ renin secretion by kidneys
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| Calcium channel blockers, treat HTN by? | causing vasodilation of arterioles by blocking movement of calcium into cells
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| A-Adrenergic blockers, treat HTN by? | Blocking peripheral a-adrenergic receptors to cause arteriole and venous dilation; NOTE: orthostatic HTN; change positions slowly
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| Direct vasodilators, treat HTN by? | acting directly on smooth muscles of arterioles to cause vasodilation; NOTE: fluid retention
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| Pt. teaching for hydrochlorothiazide (HydroDiuril) med? | include dietary source of potassium in diet
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| African Americans produce less _____ and do not respond well to _____ inhibitors. | renin, angiotension
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| Systemic vascular resistance (SVR) is ? | the force opposing the movement of blood within the blood vessels
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| Women with hypertension are more likely to suffer a ____ than an _____. | stroke, MI
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| The net effect of Sympathetic Nervous System is to increase BP by increasing both _____ and _____ | cardiac output and systemic vascular resistance
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| How should initial BP reading be performed? | take BP at least 2 times, at least 1 minute apart, record the avg. pressure as the value for the visit
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| Upon standing the systolic BP _____, while the diastolic BP _____. | decreases, increases
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| Orthostatic Hypertension is defined as what measurements? | from supine to standing position - SBP: ↓ 20+ mm Hg / DBP: ↓ 10+ mm Hg / ↑ HR 20+ BPM
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| Mean arterial pressure (MAP) formula: | MAP = (SBP +2DBP) / 3
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| Initial treatment of hypertensive emergency is to decrease MAP by? | no more than 25% within minutes to 1 hour.
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| Hypertensive emergency develops over what timeline? | days to hours
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| Hypertensive urgency develops over what timeline? | days to weeks
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| In hypertensive emergency, lowering BP too quickly can result in? | ↓ cerebral, coronary, or renal perfusion and could participate in stroke, MI or renal failure
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| The Auscultatory Gap is? | a wide gap between the first Korotkoff sound and subsequent beats (usually in older adults)
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