Chapter 36: Hypertension

Question 1

complication of hypertension affecting penis

Answer 1

erectile dysfunction

Question 2

complication which arises from a compensatory mechanism that strengthens cardiac contraction and increases cardiac output, and the increased contractility increases myocardial work and oxygen demand

Answer 2

left ventricular hypertrophy

Question 3

changes in endothelial function related to _____________ or ____________ agents can contribute to primary hypertension

Answer 3

vasoconstricting, vasodilating

Question 4

stages of hypertension: normal

Answer 4

<120 systolic AND <80 diastolic

Question 5

moderate use of alcohol has ______________ qualities

Answer 5

cardioprotective

Question 6

assessment and interventions for hypertensive crisis (6)

Answer 6

1. baseline VS, O2 saturation, bloodwork
2. continuous BP and ECG monitoring
3. heart and breath sounds
4. insert IV
5. IV antihypertensive medications as ordered
6. O2 per agency protocol

Question 7

this type of hypertensive crisis does NOT show evidence of target organ disease

Answer 7

hypertensive urgency

Question 8

in this complication, BP exceeds the ability to autoregulate, causing sudden dilation of cerebral vessels, increasing capillary permeability, and eventually causing cerebral edema

Answer 8

hypertensive encephalopathy

Question 9

for every 1 kg of weight lost, BP drops by ___ mmHg

Answer 9

1

Question 10

hypertension is more prevalent in these gender groups

Answer 10

men in young adulthood and early middle age
women 65 and older

Question 11

two examples of cerebrovascular disease (complication of hypertension)

Answer 11

stroke, transient ischemic attack

Question 12

1 drink is equivalent to

Answer 12

12 oz regular beer
5 oz wine (12%)
1.5 oz 80-proof distilled spirits

Question 13

how to calculate MAP

Answer 13

MAP= (SBP + 2DBP)/3

Question 14

two renal problems that can cause secondary hypertension

Answer 14

1. renal artery stenosis
2. glomerulonephritis

Question 15

three hidden sources of sodium to identify

Answer 15

medications, toothpaste containing baking soda, prepared and packaged foods

Question 16

restricting sodium to _________ mg/day can reduce BP even further

Answer 16

1500

Question 17

hemodynamic hallmark of hypertension is _____________________________

Answer 17

persistently increased systemic vascular resistance (SVR)

Question 18

goal for hypertensive crisis is to decrease MAP by no more than ________% or to _________ mmHg

Answer 18

20-25, 110-115

Question 19

manifestations of retinal damage (4)

Answer 19

arteriovenous nicking, narrowing of retinal arterioles, hemorrhages or exudates, papilledema

Question 20

(decreased/increased) SNS activity can contribute to primary hypertension

Answer 20

increased

Question 21

complication in which the heart’s compensatory mechanisms are overwhelmed, and the heart can no longer pump enough blood to meet demands

Answer 21

heart failure

Question 22

causes of hypertensive crisis (8)

Answer 22

1. acute aortic dissection
2. drug use (cocaine, amphetamines)
3. exacerbation of chronic hypertension
4. head injury
5. MAOIs are taken with tyramine-containing foods
6. pheochromocytoma
7. preeclampsia, eclampsia
8. rebound hypertension from abrupt withdrawal of some antihypertensive drugs

Question 23

abdominal complications of hypertension

Answer 23

aneurysm, aortic dissection

Question 24

excess sodium intake decreases effectiveness of certain _______________

Answer 24

antihypertensive drugs

Question 25

5-10% cases of hypertension

Answer 25

secondary hypertension

Question 26

elevated BP with a specific cause

Answer 26

secondary hypertension

Question 27

this complication results from ischemia from narrowing of renal blood vessels which causes atrophy of tubules, destruction of glomeruli, and eventual nephron death

Answer 27

nephrosclerosis

Question 28

three preventative measures against hypertension complications

Answer 28

eye exams, kidney function tests, keep appointments with HCP

Question 29

overproduction of ______________ hormones can contribute to primary hypertension

Answer 29

sodium-retaining

Question 30

early sign of nephrosclerosis

Answer 30

nocturia

Question 31

most common cause of the complication cerebrovascular disease

Answer 31

atherosclerosis

Question 32

two symptoms of peripheral vascular disease

Answer 32

intermittent claudication, faint or absent peripheral pulses

Question 33

hypertension is highest in this ethnic group

Answer 33

blacks

Question 34

Repeated __________ may cause development of hypertension more often

Answer 34

stress

Question 35

increased ___________ intake can contribute to primary hypertension

Answer 35

sodium

Question 36

how often should a patient with hypertension see the provider

Answer 36

every 3 months

Question 37

increased BP initially occurs with an increase in ___________ or _____________

Answer 37

cardiac output (CO), systemic vascular resistance (SVR)

Question 38

manifestations of hypertensive crisis (8)

Answer 38

blurred vision, chest pain, confusion, dyspnea, headache, nausea and vomiting, nosebleeds, seizures

Question 39

complication in which hypertension disrupts coronary artery endothelium, resulting in rigid arterial wall with narrowed lumen

Answer 39

coronary artery disease

Question 40

five drugs that can cause secondary hypertension

Answer 40

1. estrogen replacement therapy 2. oral contraceptives 3. corticosteroids 4. NSAIDs 5. SNS stimulants

Question 41

90-95% cases of hypertension

Answer 41

primary hypertension

Question 42

seven complications of hypertensive emergency

Answer 42

renal failure, retinopathy heart failure, intracranial/subarachnoid hemorrhage encephalopathy MI dissecting aortic aneurysm

Question 43

hypertensive crisis is defined as systolic BP >___ mmHg and/or diastolic BP >___ mmHg

Answer 43

180, 120

Question 44

elevated BP without an identified cause

Answer 44

primary (essential, idiopathic) hypertension

Question 45

women should limit their alcohol intake to

Answer 45

1 drink a day

Question 46

this type of hypertensive crisis shows evidence of target organ disease and most often requires hospitalization

Answer 46

hypertensive emergency

Question 47

stages of hypertension: stage 1

Answer 47

130-139 systolic OR 80-89 diastolic

Question 48

nutrition and diet recommendations

Answer 48

plant-based and Mediterranean diets with increased fruits, nuts, vegetables, legumes, lean proteins (fish/vegetables) Dietary Approaches to Stop Hypertension (DASH) diet

Question 49

how often muscle strengthening activities should be done

Answer 49

at least twice a week

Question 50

muscle strengthening activities can reduce SBP by ________

Answer 50

4-9 mmHg

Question 51

Hypertension is more common in patients who have _____________

Answer 51

diabetes

Question 52

manifestations of SEVERE retinal damage (3)

Answer 52

blurred vision, retinal hemorrhage, vision loss

Question 53

healthy adults should restrict sodium intake to _________ mg/day

Answer 53

2300

Question 54

cardiovascular benefits can be seen _____________ of stopping nicotine products

Answer 54

within 1 year

Question 55

increasing _________ and ____________ intake are associated with lower BP

Answer 55

potassium, calcium

Question 56

three endocrine problems that can cause secondary hypertension

Answer 56

1. pheochromocytoma 2. Cushing syndrome 3. thyroid disease

Question 57

three neurologic problems that can cause secondary hypertension

Answer 57

1. brain tumors 2. stroke 3. TBI

Question 58

stages of hypertension: prehypertension (elevated)

Answer 58

120-129 systolic AND <80 diastolic

Question 59

manifestations/assessment findings of nephrosclerosis (5)

Answer 59

microalbuminuria, proteinuria, microscopic hematuria, high serum creatinine (≥1.5 mg/dL), high BUN

Question 60

syndrome in which a sudden rise of BP is associated with severe headache, nausea, vomiting, seizures, confusion, and/or coma

Answer 60

hypertensive encephalopathy

Question 61

stages of hypertension: stage 2

Answer 61

≥140 systolic OR ≥90 diastolic

Question 62

____________ than ideal body weight can contribute to primary hypertension

Answer 62

greater

Question 63

Salty Six foods to avoid

Answer 63

bread products, lunch meat and cured meats, pizza, soup, sandwiches, poultry

Question 64

hypertensive urgency may be associated with these three conditions

Answer 64

stable angina, chronic heart failure, prior MI or CVA

Question 65

___________ BP rises progressively with age

Answer 65

systolic

Question 66

physical activity recommended per week

Answer 66

150 minutes moderate exercise OR 75 minutes vigorous exercise

Question 67

in this complication, hypertension speeds up the process of atherosclerosis in peripheral blood vessels

Answer 67

peripheral vascular disease

Question 68

After age 50, SBP >___ mmHg is more important cardiovascular risk factor than diastolic BP

Answer 68

140

Question 69

men should limit their alcohol intake to

Answer 69

2 drinks a day

Question 70

more severe complications can occur when hypertension and _____________ coexist

Answer 70

diabetes

Question 71

eight common causes of secondary hypertension

Answer 71

1. cirrhosis 2. coarctation or congenital narrowing of aorta 3. drug-related 4. endocrine problems 5. neurologic problems 6. pregnancy-induced 7. renal disease 8. sleep apnea

Question 72

risk of hypertension increases with _______________ obesity

Answer 72

central abdominal