Cardiac - Unit 2 - Hypertension Flashcards
BP = __ x __
CO X SV
What are the four control systems for BP?
- Arterial Baroreceptor System
- Regulation of Body Fluid Volume
- Renin Angiotensin System
- Vascular Autoregulation
What does vagus stimulation do?
Decreases HR, Increases vasodilation, Decreases BP
What does Body Fluid Volume do?
Increases fluid, increases venous return, increases CO, increases Arterial Pressure, increases diuresis
What does aldosterone do?
Retains sodium - so then our BP increases.
When is it considered hypertension?
A BP of greater than 135/85 on three or more occasions.
Which changes quicker to meet the body’s need..systolic or diastolic?
Systolic
What do systolic and diastolic reflect?
Systolic - cardiac output controlled by ANS.
Diastole - vascular resistance, preload.
Should we have the pt. sit in a chair and immediately take their BP?
No, “rest” for 5 minutes - because they’s possible!
What is primary or essential hypertension?
No known cause - 90% of HTN. Results in damage to vital organs.
What is secondary HTN?
caused by other medical condition, like renal disease, endocrine disorders, brain lesions.
What should we teach a patient with HTN?
Sodium restriction, weight reduction, reduce alcohol intake, exercise, decrease stress levels, no smoking, etc.
What is the “elevated” assessment for HTN?
E - exertional SOB L - Lack of activity E - Early morning H/A V - vascular changes/visual changes (can't see well) A - Anxiety T - Tired E - Epistaxis (nose bleeds) D - Diastolic pressure elevated
Do diuretics throw out a lot of potassium?
YES
What do thiazide diuretics do? What’s the prototype?
HCTZ - promote secretion of Na+, K+, Water — decrease Blood volume, decrease CO, etc.
Does HCTZ work with renal failure patients?
No
What do loop diuretics do? What is the prototype?
Furosemide - act on the loop of henle - good for renal patients!
What are osmotic diuretcs do?
Used more in critical care - Mannitol is the prototype!
What do potassium sparing diuretics do?
Blocks action of aldosterone and spares K+!
What do alpha adrenergic blocking agents do?
Vasodilate - Minipress (Prazosin) and Cardura (Doxosin) - smooth muscle relaxation of prostate and bladder neck.
What do centrally acting alpha 2 blockers do?
Clonidine, Methyldopa, Guanfacine - decrease in CO and bradycardia, vasodilation - SE = drowsiness, dry mouth, rebound hypertension, etc.
What do beta-adrenergic blocking agents do?
olols - decrease HR, decrease force of contraction, decrease rate of conduction through the AV node - DO NOT Mix with over the count cold meds and not for asthmatics!
What do the ACE inhibitors do?
Oprils - arterial vasodilation, Na + H2O excretion, used with Dm, Heart failure, MI - can cause hyperkalemia, A COUGH, first dose orthostatic hypotension, etc.
What do the ARB’s do?
Sartan’s - arteriole vasodilation, same as ACE Inhibitors - but no cough! :)
What do calcium channel blockers do?
Dilitiazime, Verapamil - potent arterial vasodilator - slows conduction through AV node - decrease dose slowly if you need to! DO NOT JUST STOP.
With a hypertensive crisis, like 240/120 (which is the level), do we want to get it down quickly?
No, we want to do it at a rate of about 25% decrease in the first hour…etc. Use drugs like labetalol, etc.
African Americans are at a much lower risk for having HTN. T/F?
FALSE - Ages 18-49 = 1/3 greater risk
Age 50 & higher = 2/3’s greater risk.
