Adult Health II
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| normal BP range | <120 S---<80 D
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| pre-HTN BP range | 120-139 S---80-89 D
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| HTN Stage 1 BP range | 140-159 S---90-99 D
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| HTN Stage 2 BP range | > or = 160 S---> or = 100 D
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| what is peripheral vascular resistance? | vessel constriction or dilation, which is controlled by autonomic nervous system and the hormones--epinephrine and norepinephrine
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| what is a stroke volume? | amount of blood ejected from the heart per beat
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| what is the normal cardiac output range? | 5-7 L/min
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| what is arteriosclerosis? | the thickening or hardening of the arterial walls
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| what increases CO? | increased heart rate and increased blood volume
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| what increases peripheral vascular resistance? | factors that increase blood viscosity (such as dehydration) and factors that decrease vessel diameter (such as caffenine, nicotine, meds)
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| what makes smoking a RF for HTN? | vasoconstriction, increased carbon monoxide levels, and increased platelet adhesion which may lead to thrombus formation
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| what race is at higher risk for HTN? | AA and Indians
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| 25% of cardiac OP goes where? | kidneys
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| What are some RF for secondary HTN? | renal vascular and parenchymal disease, primary aldosteronism, coarctation of the aorta. meds such as BC (estrogen), antihistamines, and erythropoetin
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| what are some common signs of HTN? | HA, dizziness, or fainting
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| how do you check for orthostatic hypotension? | take a BP reading while pt supine or sitting, then 2 min later take while standing
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| what BP reading shows orthostatic hypotension? | a decrease in BP 20 S or 10 D when pt changes positions
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| what diagnostic assessment indicates renal disease? | hematuira, proteinuria, elevated BUN, and creatinine
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| what diagnostic assessment may indicate cardiomegaly? | chest x-ray
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| what diagnostic assessment shows left artial and left ventricular enlargement? | x-ray and ECG
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| what is the Na restriction for HTN pt? | less than 2300mg/day
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| if a pt has a BMI ___ or higher weight loss is encouraged | 25
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| HTN with a BMI of 25 or higher should lose weight and have a diet consisting of ___ fat, ____ sat. fat, ___ cholesterol | less than 30% fat, less than 10% sat fat, and less than 300mg/day cholesterol
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| HTN pt should limit slcohol intake to ___ | no more than 1 oz of ethanol daily= 2 oz liquor, 8 oz wine, 24 oz beer
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| what is suggested for exerise with HTN pt? | start slow---30-45 min 3-5 times/week
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| what are 3 types of diuretics? | thiazides, loop, and K-sparing
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| what are 4 types of pharmacologic therapies for HTN? | diuretics, Ca Channel Blockers, ACE inhibitors, and ARBs
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| what is the least potent diuretic? | thiazides
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| what do thiazides do? | they prevent Na and water reabsorption in the DISTAL TUBULES and promote K excretion---so basically they help get rid of water, Na, and K
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| what are pt taking a thiazide diuretic at risk for? | hyponatriemia, hypovolemia, and hypokalemia
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| what are 2 types of thiazide diuretics? | hydrochlorothiazide (HCTZ)--Esidrix/HydroDiuril AND Chlorothiazide-- Diuril
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| what is the strongest diuretic? | loop diuretics
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| what do loop diuretics do? | they depress Na reabsorption in ASCENDING LOOP OF HENLE and promote K excretion---basically they get rid of water, Na, and K
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| what are pt taking a loop diuretic at risk for? | hyponatremia, hypovolemia, and hypokalemia
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| what are 2 types of loop diuretic? | furosemide (Lasix) and Bumetamide (Bumex)
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| what do K-sparing diuretics do? | they act on DISTAL TUBULE to inhibit Na reabsorption in exchange for K, thereby retaining K---so basically they get rid of water and Na and keep K
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| what are pt taking a K-sparing diuretic at risk for? | hyponatremia, hypovolemia, and HYPERkalemia
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| what are 2 types of K-sparing diuretics? | spironolactone (aldactone) and trimterene (Dyrenium)
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| what are the signs of hyponatremia and hypokalemia? | irregular pulse and muscle weakness
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| what do Ca channel blockers do? | they interfere with transmembrane flux of Ca ions...so basically they block Ca from entering the tissue
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| what is the result of Ca channel blockers? | vasdilation and decrease BP
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| what are 4 types of Ca channel blockers? | VERY NICE DRUGS ALWAYS---verapamil (calan, calan-SR, lsoptin), dilitaizem (cardizem, cardizem-SR), nicardipine (cardene, cardene-SR), and amiodipine (novasc)
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| if taking Ca channel blocker Dilitiazem, avoid ____ and why? | grapfruit juice bc it increases the drug level and will further decrease BP
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| what Ca channel blocker increases the effects of Digoxin? | Nicarpidine (Cardene)
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| Photosensitivity is a side effect for which Ca Channel blocker? | Amlodipine (Norvasc)--use protective clothing
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| what do angiotensin converting enzyme (ACE) inhibitors do? | they inhibit the conversion of angiotensin I to angiotensin II---basically they are preventing the vasoconstriction that angiotensin II produces
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| what are 3 types of ACE inhibitors? | "PRIL" DRUGS---captopril (capoten), enalapril (vasotec), and lisinopril (zestril, prinivil)
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| what is a common side effect of ACE inhibitors? | coughing
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| what do angiotensin II receptor antagonists (ARBS) do? | they block the binding of angiotensin II in the VASCULAR and ADRENAL tissues...so basically they prevent angiotensin from doing its job
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| what are 3 ARBS? | "SARTAN" drugs---candesarten (atacand), losartan (cozaar), and telmisarten (micardis)
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| what are 2 adverse side effects of ARBS? | angioedema (caused by Candsarten and telmisarten and losarten can cause heart failure
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| which HTN drugs are used to prevent kidney disease? | ARBS and ACE
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| which HTN drug workds best for AA? | ARBS
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| what do aldosterone receptor antagonists do? | they lower the BP by blocking aldosterone binding at the mineralocorticiod receptor site in teh kidney, heart, blood vessels, and brain...so basically receptors aren't recieving aldosterone therefore not holding in Na and water
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| what are the risks of taking aldosterone receptor antagonists? | hyperkalemia and hyponatremia
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| what do beta blockers do? | they block beta receptors in the heart and peripheral vessels, this reducing cardiac OP and BP
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| what is a beta blocker drug? | "OLOL" DRUGS---propranolol (inderal)
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| what are the 2 types of beta blokers? | cardioselective and non-cardioselective
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| beta I is used for ___ | cardiovascular---common with HTN
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| beta II is used for ___ | lungs
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| beta nonselective is used for ____ | both heart and lungs = heart rate, BP, and respirations all DECREASE
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| what should be monitored on a pt taking a beta blocker? | fatigue, weakness, depression, sexual dysfunction all due to lack of O2
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| what do artieral baroreceptors do? | they sense changes in BP
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| where are arterial baroreceptors found? | carotid sinus, aorta, and wall of left ventricle
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| if there is a rise in artial pressure (BP), the ___ nerve will be stimulated, which will cause a decrease in ____ and _____ | vagal nerve.....decrease in heart rate and vasodilation
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| with hypertension, the ____ system does not work properly | arterial baroreceptor system
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| increase in Na and water = ____ in BP | increase
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| increase in cardiac OP = increase in blood to kidneys = ___ dieresis that leads to ____ in BP | increase dieresis and decrease BP-->this occurs if there is normal kidney function
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| is released from renal cells in response to decreased BP/blood volume | renin
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| is a powerful vasoconstrictor which will increase BP levels | angiotensin II
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| is released from the adrenal glands and its function is to retain Na | aldosterone
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| regulates perfusion of tissues at a constant level | vascular autoregulation
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| what does essential HTN cause? | hyperplasia (thickening) of the arterioles
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