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Nursing 20G - Vital Signs > 15) Blood Pressure > Flashcards

15) Blood Pressure Flashcards

1
Q

What is blood pressure?

A
  • Force exerted on artery walls by pulsing blood from the heart
  • Blood flows from high pressure to low pressure areas
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2
Q

What is systemic/arterial blood pressure?

A
  • Blood pressure in the arteries of the body
  • Good indicator of cardiovascular health
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3
Q

What is systolic blood pressure?

A
  • Peak maximum pressure when heart contracts
  • Blood forced into aorta under high pressure
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4
Q

What is diastolic blood pressure?

A
  • Minimal pressure exerted on artery walls
  • When ventricles are relaxed
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5
Q

How is blood pressure measured?

A
  • In millimeters of mercury (mmHg)
  • Indicates height a column of mercury is raised
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6
Q

How is blood pressure recorded?

A
  • Systolic reading over diastolic reading (e.g. 120/80)
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7
Q

What is pulse pressure?

A
  • Difference between systolic and diastolic pressures
  • For 120/80, pulse pressure is 40
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8
Q

Why is pulse pressure important?

A
  • Potential indicator of cardiovascular disease
  • Related to arterial compliance/stiffness
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9
Q

What factors influence arterial blood pressure?

A
  • Cardiac output
  • Peripheral vascular resistance
  • Blood volume
  • Blood viscosity
  • Artery elasticity
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10
Q

Why is knowledge of hemodynamic variables important?

A
  • Helps in assessing blood pressure alterations
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11
Q

How does cardiac output affect blood pressure?

A
  • As cardiac output increases, more blood is pumped against artery walls
  • This causes blood pressure to rise
  • Cardiac output increases from increased heart rate, contractility, or blood volume
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12
Q

How does a rapid heart rate increase affect blood pressure?

A
  • Decreases heart’s ability to fill properly
  • Results in decreased blood pressure
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13
Q

What is peripheral vascular resistance?

A
  • Resistance to blood flow determined by vessel diameter and tone
  • Smaller lumen = greater resistance to flow
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14
Q

How does peripheral resistance affect blood pressure?

A
  • As resistance rises, arterial blood pressure rises
  • As vessels dilate and resistance falls, blood pressure decreases
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15
Q

How do arteries and arterioles regulate blood flow?

A
  • Surrounded by smooth muscle that constricts/dilates
  • Constriction decreases blood supply to that area
  • Allows more blood to major organs requiring it
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16
Q

How does blood volume affect blood pressure?

A
  • Most adults have ~5000 mL circulating blood volume
  • Increased volume exerts more pressure on artery walls
  • Decreased volume (hemorrhage, dehydration) reduces blood pressure
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17
Q

What is blood viscosity?

A
  • Thickness/resistance of blood flow through vessels
  • Determined by percentage of red blood cells (hematocrit)
  • Higher hematocrit = more viscous blood = higher blood pressure
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18
Q

How does artery elasticity affect blood pressure?

A
  • Elastic arteries accommodate pressure changes without fluctuations
  • Reduced elasticity (arteriosclerosis) increases resistance
  • Rigid arteries cannot expand for stroke volume = higher systolic pressure
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19
Q

How are hemodynamic factors interrelated?

A
  • Each factor significantly impacts the others
  • Reduced elasticity increases peripheral resistance
  • Body compensates for changes to maintain stable pressure
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20
Q

What is the normal state of artery walls?

A
  • Elastic and easily distensible
  • Expand in diameter to accommodate pressure changes
  • Prevents wide fluctuations in blood pressure
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21
Q

How do diseases like arteriosclerosis affect artery walls?

A
  • Walls lose elasticity and become rigid
  • Replaced by fibrous tissue that cannot stretch well
  • Increases resistance to blood flow
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22
Q

How does reduced elasticity impact blood pressure?

A
  • Vessels cannot expand for stroke volume
  • Blood forced through rigid walls
  • Systolic pressure significantly elevated
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23
Q

Why is a single blood pressure measurement inadequate?

A
  • Blood pressure is not constant
  • It changes from heartbeat to heartbeat
  • Influenced by many factors
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24
Q

What should guide nursing interventions for blood pressure?

A
  • Blood pressure trends over time
  • Not just individual measurements
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25
Why is understanding influencing factors important?
- Allows more accurate interpretation of readings - Provides context for blood pressure values
26
How does blood pressure change in childhood?
- Increases during childhood - Assessed based on age and body size - Larger/taller children have higher BP for their age
27
What are normal BP ranges in children?
- 6-12 months: 80-100/55-65 mmHg - 3-6 years: 95-110/60-75 mmHg
28
How does blood pressure change in adulthood?
- Tends to increase with advancing age - Systolic BP and pulse pressure may rise due to artery stiffness
29
What are BP treatment targets in adults?
- Most adults: <140/90 mmHg - Diabetes: <130/80 mmHg - High normal BP requires annual monitoring
30
How does stress affect the body?
- Stimulates sympathetic nervous system - Increases heart rate, cardiac output, peripheral resistance - These changes raise blood pressure
31
What emotional states can increase blood pressure?
- Anxiety - Fear - Pain - Other emotional stress
32
How much can anxiety raise blood pressure?
- Anxiety can raise blood pressure by up to 30 mmHg
33
Do patients with male or female genitalia have different baseline blood pressure levels?
- No clinically significant differences - After puberty, those with male genitalia tend to have higher readings
34
What factors can increase hypertension risk in those with female genitalia?
- Pregnancy - Birth control - Menopause
35
After what age are those with female genitalia more likely to have higher blood pressure?
- After age 65
36
What is the diurnal rhythm of blood pressure?
- Daily peak and trough pattern - Steep increase in the morning - Peaks in late afternoon - Decreases at night during rest
37
When is blood pressure highest during the day?
- Late afternoon
38
When is blood pressure lowest?
- At night during rest
39
What medications can lower blood pressure?
- Antihypertensive drugs - Other cardiac medications - Opioid analgesics
40
What can increase blood pressure?
- Vasoconstrictors - Excess intravenous fluids
41
Why assess blood pressure before medication administration?
- Some medications directly or indirectly affect blood pressure - Critical to have a baseline reading
42
For low risk patients, what BP level requires antihypertensive therapy initiation?
- SBP ≥ 160 mmHg - DBP ≥ 100 mmHg
43
What are the BP treatment targets for low risk patients?
- SBP < 140 mmHg - DBP < 90 mmHg
44
For high cardiovascular risk patients, what BP level requires therapy initiation?
- SBP ≥ 130 mmHg
45
What is the SBP treatment target for high CV risk patients?
- SBP < 120 mmHg
46
For patients with diabetes, what BP levels require antihypertensive therapy?
- SBP ≥ 130 mmHg - DBP ≥ 80 mmHg
47
What are the BP treatment targets for diabetic patients?
- SBP < 130 mmHg - DBP < 80 mmHg
48
For all other patients, what BP level requires therapy initiation?
- SBP ≥ 140 mmHg - DBP ≥ 90 mmHg
49
What are the general BP treatment targets?
- SBP < 140 mmHg - DBP < 90 mmHg
50
What do diuretics do?
- Reduce kidneys' reabsorption of sodium and water - Lower circulating fluid volume
51
How do β-blockers lower blood pressure?
- Block sympathetic nerve impulses - Reduce heart rate and cardiac output
52
What is the mechanism of action for vasodilators?
- Act on arteriolar smooth muscle - Cause relaxation and reduce peripheral resistance
53
How do calcium channel blockers reduce blood pressure?
- Cause systemic vasodilation - Reduce peripheral vascular resistance
54
What do ACE inhibitors prevent?
- Block conversion of angiotensin I to angiotensin II - Prevent vasoconstriction - Reduce aldosterone and fluid retention
55
How do angiotensin II receptor blockers work?
- Block binding of angiotensin II - Prevent vasoconstriction
56
How does exercise affect blood pressure?
- Blood pressure can be reduced for several hours after exercise
57
What happens to older adults' blood pressure after eating?
- Often experience 5-10 mmHg drop about 1 hour after eating
58
How does activity affect blood pressure?
- Increased oxygen demand leads to increased blood pressure
59
Is obesity linked to hypertension?
- Yes, obesity is a factor in hypertension
60
How does smoking impact blood pressure?
- Causes vasoconstriction - Blood pressure rises during smoking - Returns to baseline 15 minutes after smoking stops
61
What is the most common blood pressure alteration?
- Hypertension
62
What are the effects of hypertension on arteries?
- Thickening of arterial walls - Loss of elasticity in arterial walls - Increased peripheral vascular resistance
63
How does hypertension impact the heart and blood flow?
- Heart must pump against greater resistance - Decreased blood flow to vital organs like heart, brain, kidney
64
When should hypertension be diagnosed and treated immediately?
- If patient exhibits features of hypertensive urgency or emergency
65
What blood pressure readings indicate hypertension diagnosis via office measurement?
- MBP ≥180/110 mmHg - AOBP 135-179/85-109 mmHg - OBPM 140-179/90-109 mmHg
66
How is hypertension diagnosed via ambulatory monitoring?
- Mean SBP ≥135 or DBP ≥85 mmHg - 24-hr mean SBP ≥130 or DBP ≥80 mmHg
67
When is home blood pressure monitoring (HBPM) used?
- If ambulatory monitoring is not tolerated or available - Consists of 2 readings morning and evening for 7 days (28 total) - Discard first day's readings, average last 6 days
68
What home BP readings indicate hypertension diagnosis?
- Mean SBP ≥135 mmHg - Mean DBP ≥85 mmHg
69
What should nurses do regarding BP measurement?
- Incorporate recommendations into practice - Correctly interpret BP and minimize error
70
What is white coat hypertension?
- BP elevated during healthcare visits - Patients more likely to develop true hypertension
71
What is masked hypertension?
- BP normal during healthcare visits - BP elevated at home
72
What advice was given to M.J. regarding white coat hypertension?
- Monitor blood pressure at home - Reduce sodium intake - Exercise regularly
73
What lifestyle factors increase hypertension risk?
- Physical inactivity - Poor diet low in fruits/veggies - Overweight/obesity - Diabetes - Chronic kidney disease
74
What lifestyle changes help prevent/treat hypertension?
- Increase physical activity - Weight reduction - Moderate alcohol - Eat healthier - Relaxation therapies - Quit smoking
75
What are the major risks associated with hypertension?
- Major risk factor for cardiovascular disease - Number one risk factor for stroke
76
Who is at significant risk for developing hypertension and cardiovascular disease?
- People with a family history of hypertension
77
What type of disease is cardiovascular disease?
- A noncommunicable disease (NCD)
78
What blood pressure level indicates hypotension?
- Systolic blood pressure ≤ 90 mmHg
79
Is low blood pressure always abnormal?
- For most people, yes - it is associated with illness - Some adults may have low BP normally
80
What causes hypotension?
- Dilation of arteries in vascular bed - Substantial blood volume loss (e.g. hemorrhage) - Failure of heart to pump adequately (e.g. myocardial infarction)
81
What symptoms indicate life-threatening hypotension?
- Pallor - Skin mottling - Clamminess - Confusion - Increased heart rate - Decreased urine output
82
What should be done for life-threatening hypotension?
- Report to healthcare provider immediately
83
What risk factors contribute to most CVDs?
- Tobacco use - Unhealthy diet and obesity - Physical inactivity - Harmful alcohol use
84
What is orthostatic/postural hypotension?
- Low blood pressure when rising to upright position - Occurs in normotensive (normal BP) individuals
85
What happens in healthy individuals when standing?
- Blood vessels in legs constrict - Prevents blood pooling due to gravity - No symptoms felt
86
What happens in volume-depleted patients when standing?
- Blood pressure drops significantly - Heart rate increases to compensate for low cardiac output
87
Who is at risk for orthostatic hypotension?
- Dehydrated patients - Anemic patients - Prolonged bed rest - Recent blood loss
88
How is orthostatic hypotension assessed?
- BP and pulse taken supine, sitting, standing - Readings 1-3 mins after position change - Observe for symptoms like fainting, weakness
89
How should orthostatic BP be recorded?
- Note patient position with each reading e.g. 140/80 supine, 132/72 sitting, 108/60 standing
90
Who should perform orthostatic measurements?
- Requires advanced nursing judgment - Should not be delegated to unregulated providers

Nursing 20G - Vital Signs (19 decks)

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