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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
Q

Why is understanding influencing factors important?

A
  • Allows more accurate interpretation of readings
  • Provides context for blood pressure values
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26
Q

How does blood pressure change in childhood?

A
  • Increases during childhood
  • Assessed based on age and body size
  • Larger/taller children have higher BP for their age
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27
Q

What are normal BP ranges in children?

A
  • 6-12 months: 80-100/55-65 mmHg
  • 3-6 years: 95-110/60-75 mmHg
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28
Q

How does blood pressure change in adulthood?

A
  • Tends to increase with advancing age
  • Systolic BP and pulse pressure may rise due to artery stiffness
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29
Q

What are BP treatment targets in adults?

A
  • Most adults: <140/90 mmHg
  • Diabetes: <130/80 mmHg
  • High normal BP requires annual monitoring
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30
Q

How does stress affect the body?

A
  • Stimulates sympathetic nervous system
  • Increases heart rate, cardiac output, peripheral resistance
  • These changes raise blood pressure
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31
Q

What emotional states can increase blood pressure?

A
  • Anxiety
  • Fear
  • Pain
  • Other emotional stress
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32
Q

How much can anxiety raise blood pressure?

A
  • Anxiety can raise blood pressure by up to 30 mmHg
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33
Q

Do patients with male or female genitalia have different baseline blood pressure levels?

A
  • No clinically significant differences
  • After puberty, those with male genitalia tend to have higher readings
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34
Q

What factors can increase hypertension risk in those with female genitalia?

A
  • Pregnancy
  • Birth control
  • Menopause
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35
Q

After what age are those with female genitalia more likely to have higher blood pressure?

A
  • After age 65
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36
Q

What is the diurnal rhythm of blood pressure?

A
  • Daily peak and trough pattern
  • Steep increase in the morning
  • Peaks in late afternoon
  • Decreases at night during rest
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37
Q

When is blood pressure highest during the day?

A
  • Late afternoon
38
Q

When is blood pressure lowest?

A
  • At night during rest
39
Q

What medications can lower blood pressure?

A
  • Antihypertensive drugs
  • Other cardiac medications
  • Opioid analgesics
40
Q

What can increase blood pressure?

A
  • Vasoconstrictors
  • Excess intravenous fluids
41
Q

Why assess blood pressure before medication administration?

A
  • Some medications directly or indirectly affect blood pressure
  • Critical to have a baseline reading
42
Q

For low risk patients, what BP level requires antihypertensive therapy initiation?

A
  • SBP ≥ 160 mmHg
  • DBP ≥ 100 mmHg
43
Q

What are the BP treatment targets for low risk patients?

A
  • SBP < 140 mmHg
  • DBP < 90 mmHg
44
Q

For high cardiovascular risk patients, what BP level requires therapy initiation?

A
  • SBP ≥ 130 mmHg
45
Q

What is the SBP treatment target for high CV risk patients?

A
  • SBP < 120 mmHg
46
Q

For patients with diabetes, what BP levels require antihypertensive therapy?

A
  • SBP ≥ 130 mmHg
  • DBP ≥ 80 mmHg
47
Q

What are the BP treatment targets for diabetic patients?

A
  • SBP < 130 mmHg
  • DBP < 80 mmHg
48
Q

For all other patients, what BP level requires therapy initiation?

A
  • SBP ≥ 140 mmHg
  • DBP ≥ 90 mmHg
49
Q

What are the general BP treatment targets?

A
  • SBP < 140 mmHg
  • DBP < 90 mmHg
50
Q

What do diuretics do?

A
  • Reduce kidneys’ reabsorption of sodium and water
  • Lower circulating fluid volume
51
Q

How do β-blockers lower blood pressure?

A
  • Block sympathetic nerve impulses
  • Reduce heart rate and cardiac output
52
Q

What is the mechanism of action for vasodilators?

A
  • Act on arteriolar smooth muscle
  • Cause relaxation and reduce peripheral resistance
53
Q

How do calcium channel blockers reduce blood pressure?

A
  • Cause systemic vasodilation
  • Reduce peripheral vascular resistance
54
Q

What do ACE inhibitors prevent?

A
  • Block conversion of angiotensin I to angiotensin II
  • Prevent vasoconstriction
  • Reduce aldosterone and fluid retention
55
Q

How do angiotensin II receptor blockers work?

A
  • Block binding of angiotensin II
  • Prevent vasoconstriction
56
Q

How does exercise affect blood pressure?

A
  • Blood pressure can be reduced for several hours after exercise
57
Q

What happens to older adults’ blood pressure after eating?

A
  • Often experience 5-10 mmHg drop about 1 hour after eating
58
Q

How does activity affect blood pressure?

A
  • Increased oxygen demand leads to increased blood pressure
59
Q

Is obesity linked to hypertension?

A
  • Yes, obesity is a factor in hypertension
60
Q

How does smoking impact blood pressure?

A
  • Causes vasoconstriction
  • Blood pressure rises during smoking
  • Returns to baseline 15 minutes after smoking stops
61
Q

What is the most common blood pressure alteration?

A
  • Hypertension
62
Q

What are the effects of hypertension on arteries?

A
  • Thickening of arterial walls
  • Loss of elasticity in arterial walls
  • Increased peripheral vascular resistance
63
Q

How does hypertension impact the heart and blood flow?

A
  • Heart must pump against greater resistance
  • Decreased blood flow to vital organs like heart, brain, kidney
64
Q

When should hypertension be diagnosed and treated immediately?

A
  • If patient exhibits features of hypertensive urgency or emergency
65
Q

What blood pressure readings indicate hypertension diagnosis via office measurement?

A
  • MBP ≥180/110 mmHg
  • AOBP 135-179/85-109 mmHg
  • OBPM 140-179/90-109 mmHg
66
Q

How is hypertension diagnosed via ambulatory monitoring?

A
  • Mean SBP ≥135 or DBP ≥85 mmHg
  • 24-hr mean SBP ≥130 or DBP ≥80 mmHg
67
Q

When is home blood pressure monitoring (HBPM) used?

A
  • 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
Q

What home BP readings indicate hypertension diagnosis?

A
  • Mean SBP ≥135 mmHg
  • Mean DBP ≥85 mmHg
69
Q

What should nurses do regarding BP measurement?

A
  • Incorporate recommendations into practice
  • Correctly interpret BP and minimize error
70
Q

What is white coat hypertension?

A
  • BP elevated during healthcare visits
  • Patients more likely to develop true hypertension
71
Q

What is masked hypertension?

A
  • BP normal during healthcare visits
  • BP elevated at home
72
Q

What advice was given to M.J. regarding white coat hypertension?

A
  • Monitor blood pressure at home
  • Reduce sodium intake
  • Exercise regularly
73
Q

What lifestyle factors increase hypertension risk?

A
  • Physical inactivity
  • Poor diet low in fruits/veggies
  • Overweight/obesity
  • Diabetes
  • Chronic kidney disease
74
Q

What lifestyle changes help prevent/treat hypertension?

A
  • Increase physical activity
  • Weight reduction
  • Moderate alcohol
  • Eat healthier
  • Relaxation therapies
  • Quit smoking
75
Q

What are the major risks associated with hypertension?

A
  • Major risk factor for cardiovascular disease
  • Number one risk factor for stroke
76
Q

Who is at significant risk for developing hypertension and cardiovascular disease?

A
  • People with a family history of hypertension
77
Q

What type of disease is cardiovascular disease?

A
  • A noncommunicable disease (NCD)
78
Q

What blood pressure level indicates hypotension?

A
  • Systolic blood pressure ≤ 90 mmHg
79
Q

Is low blood pressure always abnormal?

A
  • For most people, yes - it is associated with illness
  • Some adults may have low BP normally
80
Q

What causes hypotension?

A
  • Dilation of arteries in vascular bed
  • Substantial blood volume loss (e.g. hemorrhage)
  • Failure of heart to pump adequately (e.g. myocardial infarction)
81
Q

What symptoms indicate life-threatening hypotension?

A
  • Pallor
  • Skin mottling
  • Clamminess
  • Confusion
  • Increased heart rate
  • Decreased urine output
82
Q

What should be done for life-threatening hypotension?

A
  • Report to healthcare provider immediately
83
Q

What risk factors contribute to most CVDs?

A
  • Tobacco use
  • Unhealthy diet and obesity
  • Physical inactivity
  • Harmful alcohol use
84
Q

What is orthostatic/postural hypotension?

A
  • Low blood pressure when rising to upright position
  • Occurs in normotensive (normal BP) individuals
85
Q

What happens in healthy individuals when standing?

A
  • Blood vessels in legs constrict
  • Prevents blood pooling due to gravity
  • No symptoms felt
86
Q

What happens in volume-depleted patients when standing?

A
  • Blood pressure drops significantly
  • Heart rate increases to compensate for low cardiac output
87
Q

Who is at risk for orthostatic hypotension?

A
  • Dehydrated patients
  • Anemic patients
  • Prolonged bed rest
  • Recent blood loss
88
Q

How is orthostatic hypotension assessed?

A
  • BP and pulse taken supine, sitting, standing
  • Readings 1-3 mins after position change
  • Observe for symptoms like fainting, weakness
89
Q

How should orthostatic BP be recorded?

A
  • Note patient position with each reading
    e.g. 140/80 supine, 132/72 sitting, 108/60 standing
90
Q

Who should perform orthostatic measurements?

A
  • Requires advanced nursing judgment
  • Should not be delegated to unregulated providers

Nursing 20G - Vital Signs (19 decks)

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