Assessment and management of HTN Flashcards
Risk factors for HTN
65+
Non-Hispanic blacks
Medicare coverage
Mexican Americans
Genetics
Diet
Obesity
Smoking
Obstructive sleep
Pre-Hypertension ranges
120-139 /OR 80-90
Stage I Hypertension
140-159/ OR 90-99
Stage II Hypertension
160+ /OR 100+
Hypertension definition
Systolic greater than 150 and diastolic greater than 90
What is the diagnosis of HTN based on?
The average of 2 or more accurate BP measurements by medical professionals on 2 or more occasions 1-4 weeks apart
Primary HTN cause
undetermined cause
Secondary HTN cause
identifiable cause
- renal parenchymal disease
- hyperaldosteronism
- meds
-coaction of aorta
- pregnancy
- sleep apnea
Symptoms/ clinical manifestations of HTN
Most often asymptomatic (Silent Killer) !!
Symptoms occur when vascular damage has occurred in target organs with involved vessels.
HTN target organs
heart
brain
kidneys
eyes
Manifestations of vascular damage in target organs
retinal damage/ eye changes
renal damage
myocardial infarction
heart failure
cardiac hypertrophy (LV)
Stroke
PAD
Medical management of outline
Goal: Maintain BP at 140/ 90 or lower
treatment as inexpensive, simple, and least disruptive as possible
Examples of HTN treatment
Meds
Lifestyle modifications: weight loss, DASH diet, physical activity, decreased alcohol
What is the Pharmacological treatments for HTN?
ACE/ ARBS
Diuretics
Beta Blockers
How are doses made for meds to treat HTN?
gradually increase until target BP is reached
- add additional meds of needed
Nursing management of HTN (ASSESMENT)
History and physical assessment
- risk factors
- accurate BP measurement s
- assess impact of HTN on the body, personal and social factors.
Nursing diagnosis related to HTN
deficit knowledge regarding the relation between treatment regimen and control of the disease process
Noncompliance with therapeutic regimen related to the side effects of prescribed therapy
collaborative problems with HTN
Left ventricular hypertrophy
Myocardial infarction
TIA
Heart failure
Stroke
Renal insufficiency or failure
Renal hemorrhage
Planning and goals for patients with HTN
Understanding disease process and treatment
Participation in a self care program
Absence of compliance
Nursing interventions for HTN
Education
Consults/ collaboration with dietician
Promotion of adherence to to treatment regimen
Follow up care
Emphasis on life long process and changes
Gerontologic considerations
Difficulty remembering medication regimen
(predispose or orthostatic hypo and vol. depletion)
Expense challenges
Monotherapy
if appropriate, can help to simplify meds for older adults
