Chapter 36: Hypertension Flashcards
complication of hypertension affecting penis
erectile dysfunction
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
left ventricular hypertrophy
changes in endothelial function related to _____________ or ____________ agents can contribute to primary hypertension
vasoconstricting, vasodilating
stages of hypertension: normal
<120 systolic AND <80 diastolic
moderate use of alcohol has ______________ qualities
cardioprotective
assessment and interventions for hypertensive crisis (6)
- baseline VS, O2 saturation, bloodwork
- continuous BP and ECG monitoring
- heart and breath sounds
- insert IV
- IV antihypertensive medications as ordered
- O2 per agency protocol
this type of hypertensive crisis does NOT show evidence of target organ disease
hypertensive urgency
in this complication, BP exceeds the ability to autoregulate, causing sudden dilation of cerebral vessels, increasing capillary permeability, and eventually causing cerebral edema
hypertensive encephalopathy
for every 1 kg of weight lost, BP drops by ___ mmHg
1
hypertension is more prevalent in these gender groups
men in young adulthood and early middle age
women 65 and older
two examples of cerebrovascular disease (complication of hypertension)
stroke, transient ischemic attack
1 drink is equivalent to
12 oz regular beer
5 oz wine (12%)
1.5 oz 80-proof distilled spirits
how to calculate MAP
MAP= (SBP + 2DBP)/3
two renal problems that can cause secondary hypertension
- renal artery stenosis
- glomerulonephritis
three hidden sources of sodium to identify
medications, toothpaste containing baking soda, prepared and packaged foods
restricting sodium to _________ mg/day can reduce BP even further
1500
hemodynamic hallmark of hypertension is _____________________________
persistently increased systemic vascular resistance (SVR)
goal for hypertensive crisis is to decrease MAP by no more than ________% or to _________ mmHg
20-25, 110-115
manifestations of retinal damage (4)
arteriovenous nicking, narrowing of retinal arterioles, hemorrhages or exudates, papilledema
(decreased/increased) SNS activity can contribute to primary hypertension
increased
complication in which the heart’s compensatory mechanisms are overwhelmed, and the heart can no longer pump enough blood to meet demands
heart failure
causes of hypertensive crisis (8)
- acute aortic dissection
- drug use (cocaine, amphetamines)
- exacerbation of chronic hypertension
- head injury
- MAOIs are taken with tyramine-containing foods
- pheochromocytoma
- preeclampsia, eclampsia
- rebound hypertension from abrupt withdrawal of some antihypertensive drugs
abdominal complications of hypertension
aneurysm, aortic dissection
excess sodium intake decreases effectiveness of certain _______________
antihypertensive drugs
5-10% cases of hypertension
secondary hypertension
elevated BP with a specific cause
secondary hypertension
this complication results from ischemia from narrowing of renal blood vessels which causes atrophy of tubules, destruction of glomeruli, and eventual nephron death
nephrosclerosis
three preventative measures against hypertension complications
eye exams, kidney function tests, keep appointments with HCP
overproduction of ______________ hormones can contribute to primary hypertension
sodium-retaining
early sign of nephrosclerosis
nocturia
most common cause of the complication cerebrovascular disease
atherosclerosis
two symptoms of peripheral vascular disease
intermittent claudication, faint or absent peripheral pulses
hypertension is highest in this ethnic group
blacks
Repeated __________ may cause development of hypertension more often
stress
increased ___________ intake can contribute to primary hypertension
sodium
how often should a patient with hypertension see the provider
every 3 months
increased BP initially occurs with an increase in ___________ or _____________
cardiac output (CO), systemic vascular resistance (SVR)
manifestations of hypertensive crisis (8)
blurred vision, chest pain, confusion, dyspnea, headache, nausea and vomiting, nosebleeds, seizures
complication in which hypertension disrupts coronary artery endothelium, resulting in rigid arterial wall with narrowed lumen
coronary artery disease
five drugs that can cause secondary hypertension
- estrogen replacement therapy
- oral contraceptives
- corticosteroids
- NSAIDs
- SNS stimulants
90-95% cases of hypertension
primary hypertension
seven complications of hypertensive emergency
renal failure, retinopathy
heart failure, intracranial/subarachnoid hemorrhage
encephalopathy
MI
dissecting aortic aneurysm
hypertensive crisis is defined as systolic BP >___ mmHg and/or diastolic BP >___ mmHg
180, 120
elevated BP without an identified cause
primary (essential, idiopathic) hypertension
women should limit their alcohol intake to
1 drink a day
this type of hypertensive crisis shows evidence of target organ disease and most often requires hospitalization
hypertensive emergency
stages of hypertension: stage 1
130-139 systolic OR 80-89 diastolic
nutrition and diet recommendations
plant-based and Mediterranean diets with increased fruits, nuts, vegetables, legumes, lean proteins (fish/vegetables)
Dietary Approaches to Stop Hypertension (DASH) diet
how often muscle strengthening activities should be done
at least twice a week
muscle strengthening activities can reduce SBP by ________
4-9 mmHg
Hypertension is more common in patients who have _____________
diabetes
manifestations of SEVERE retinal damage (3)
blurred vision, retinal hemorrhage, vision loss
healthy adults should restrict sodium intake to _________ mg/day
2300
cardiovascular benefits can be seen _____________ of stopping nicotine products
within 1 year
increasing _________ and ____________ intake are associated with lower BP
potassium, calcium
three endocrine problems that can cause secondary hypertension
- pheochromocytoma
- Cushing syndrome
- thyroid disease
three neurologic problems that can cause secondary hypertension
- brain tumors
- stroke
- TBI
stages of hypertension: prehypertension (elevated)
120-129 systolic AND <80 diastolic
manifestations/assessment findings of nephrosclerosis (5)
microalbuminuria, proteinuria, microscopic hematuria, high serum creatinine (≥1.5 mg/dL), high BUN
syndrome in which a sudden rise of BP is associated with severe headache, nausea, vomiting, seizures, confusion, and/or coma
hypertensive encephalopathy
stages of hypertension: stage 2
≥140 systolic OR ≥90 diastolic
____________ than ideal body weight can contribute to primary hypertension
greater
Salty Six foods to avoid
bread products, lunch meat and cured meats, pizza, soup, sandwiches, poultry
hypertensive urgency may be associated with these three conditions
stable angina, chronic heart failure, prior MI or CVA
___________ BP rises progressively with age
systolic
physical activity recommended per week
150 minutes moderate exercise OR 75 minutes vigorous exercise
in this complication, hypertension speeds up the process of atherosclerosis in peripheral blood vessels
peripheral vascular disease
After age 50, SBP >___ mmHg is more important cardiovascular risk factor than diastolic BP
140
men should limit their alcohol intake to
2 drinks a day
more severe complications can occur when hypertension and _____________ coexist
diabetes
eight common causes of secondary hypertension
- cirrhosis
- coarctation or congenital narrowing of aorta
- drug-related
- endocrine problems
- neurologic problems
- pregnancy-induced
- renal disease
- sleep apnea
risk of hypertension increases with _______________ obesity
central abdominal
