Blood Pressure Flashcards
what is blood pressure?
the arterial wall force due to heart pumping blood.
what are the 4 factors that affect blood pressure
4 factors affect blood pressure: Force of the blood pumped Amount of blood pumped Size of the arteries Flexibility of the arteries
what is blood pressure dependent on?
Dependent on: Activity Temperature Diet Emotional state Posture Physical state Medication use
what is blood pressure expressed in? where can it be measured?
Systolic blood pressure/Diastolic pressure
Expressed in mm of mercury (Hg)
It can be measured on the right or left arm, or even thigh.
how many mmHg does the right and left arm differ?
5 mmHg
Patient can sit, recline, or be supine
True or False
True
Hypertension is diagnosed in a single reading.
True or False
False
May see effects of the disease on vision or the eye.
what is Hypertensive retinopathy?
retinal arteries narrow and constricted. blood vessels leak causing hemorrhages and exudates.
small areas of local hypoxia are known as what?
cotton wool spots= dead spots of the retina in the NFL. (nerve fiber layer)
what is hard exudates and papilloedema?
Proteins develop in vessels= hard exudates
PAPILLOEDEMA= FEATURE OF MALIGNANT HYPERTENSION.
What can hypertension cause? Describe the conditions and diseases.
Hypertension could also cause:
1) Sub-conjunctival hemorrhage (takes about 2 weeks to go away, turn yellowing or green before go away) caused by anything that makes you strain hard.
2) Retinal artery occlusion (whole retina dead and dysfunctional)
3) Retinal vein occlusion (central retinal artery strain blood in vein)
4) Retinal artery macro-aneurysms (out pouchings)
5) Exudative retinal detachments (fluid will
Lift retina and it will tear)
6) Oculo-motor palsies (eye will turn in)
Hyper- and hypotension could contribute to diseases like what?
Open angle glaucoma
TIA / Amaurosis fugax
loss of vision in one eye due to a temporary lack of O2 in retina. What is this called?
amaurosis fugax
what are the 4 stages of hypertension? and what classifies them?
Stages of Hypertension: Normal: less than 120/80 Pre-hypertension: 120-139/80-90 Stage 1 hypertension: 140-159/90-99 Stage 2 hypertension: >160/>99
Elevation of blood pressure due to anxiety of being in a doctor’s office seen in 20-30% of the population
what is this a description of?
white coat syndrome
Extremely high blood pressure In malignant hypertension: Optic nerve may be affected (IMPORTANT) It may become swollen Aka papilledema All the findings of hypertensive retinopathy PLUS swollen optic nerve head May present with occipital headaches
what is this a description of? what type of hypertension?
malignant hypertension
Malignant hypertension is included in the 4 stages of hypertension.
True or False.
False. No it is not included. it is its own entity.
no identifiable underlying cause.
what type of hypertension am I?
essential hypertension
1) Pre-eclampsia and eclampsia (rise in BP during pregnancy)
2) Pheochromocytoma (tumor in kidney BP increase significant) males more at risk
3) Kidney disease (cant regulate fluids)
4) Adrenal disease (increase bp significantly)
what type of hypertension am I?
Secondary Hypertension
what is Pheochromocytoma?
tumor in kidney BP increases significantly
what is pre-eclampsia?
rise in BP during pregnancy.
Pregnancy
20 weeks of gestation
All the findings of malignant hypertension
At risk for bilateral occipital lobe infarction
Cortical blindness
Usually defer routine dilated eye exam in pregnant women
Must dilate and care for women with this presentation!
Work in conjunction with OB-GYN and pediatrician
what type of hypertension am I?
pre-eclampsia or eclampsia hypertensive retinopathy
urgency depends on BP and symptoms.
True or False
True
what are the classifications or parameters that classify that a patient is an urgent hypertension patient case?
Patients with symptoms are always urgent: Chest pain Difficulty breathing Headache Blurred vision Optic disc swelling Diastolic of 110-120 mm Hg
what is a sphygmanometer?
Sphygmanometer (blood pressure cuff):
12-14 cm wide
what is a stethoscope used for in taking BP?
Stethoscope:
Is used to listen to the sound of the blood in the brachial artery after first compressing it completely and then letting it flow back in a controlled fashion
what does the diaphragm and bell of the stethoscope measure?
diaphragm= high pitch sounds bell= low pitch sounds
what are the sounds that you hear when measuring BP?
Korotkoff sounds
how many phases of Korotkoff sounds are there? Describe them.
5 phases: Phase I: soft tapping, systolic reading Phase II: swishing murmur Phase III: crisper sound Phase IV: abrupt sound muffling Phase V: disappearance of sounds
How long should you listen for the BP before deflating it? How do you record the BP in the proper way?
Listen for an additional 20-30 mmHg then deflate rapidly
Record:
120/80 mmHg R.A.S @ 5pm. Adult cuff.
What are the requirements or standards of taking BP normally? after caffeine, smoking, or exercise how long should you wait?
Performed after FIVE minutes at rest
30 minutes after caffeine, smoking, exercise
Arm supported at waist level Stethoscope bulb at heart level Thin sleeve or bare arm Feet flat on floor, legs uncrossed Locate brachial artery by palpation Wrap cuff about one inch above arm crease
what are the instructions of finding the systolic pressure?
Palpate the radial artery with middle and forefinger
Inflate cuff 30 mmHg above where the pulse disappears (is no longer felt)
Deflate the cuff slowly 2-3 mmHg per second until you can first palpate the beat again
Rapidly deflate the cuff
Insert earpieces of the stethoscope angled forward
Insert diaphragm firmly over the brachial artery
Inflate the cuff to 20-30 mmHg above estimated systolic pressure
Release pressure slowly
Listen for Korotkoff sounds
True or False
True
