[Exam 1] Chapter 31: Assessment and Management of Patients with Hypertension (Page 884-899)

Question 1

Hypertension defined by

Answer 1

a systolic pressure greater than 140 of diastolic pressure of 90 or higher

Question 2

What is Prehypertension

Answer 2

120-139/80-89

Question 3

What is Stage 1 Hypetension

Answer 3

140-159 / 90-99

Question 4

What is Stage 2 Hypertension

Answer 4

> 160 - > 100

Question 5

95% of patients with high blood pressure have

Answer 5

primary hypertension, which is high blood pressure from an unidentified cause

Question 6

Remaining 5% of patients with high blood presure have

Answer 6

secondary hypertension, which occursw when a cuase for the high blood pressure can be identified.

This includes chronic kidney didsease, renal artery stenosis, hyperaldosteronism

Question 7

When signs eventually appear , they usually indicate

Answer 7

vascular damage with specific manifestations related to the organs served by the involves vessels

Question 8

What happens to the left ventricle in response to the extra work?

Answer 8

Hyperthrophy occurs.

Question 9

Lab studies include

Answer 9

Urinalysis

Blood Chemistry (Na, K, Creatinine, Fastining Glucose, and Cholesterol) and 12 lead electocardiogram

Question 10

Renal damage may be suggsted by

Answer 10

elevations in BUN and Creatinine levels

Question 11

Research findings demonstrate that what can be done to reduce blood pressure?

Answer 11

Weight loss, reduced alcohol and sodium intake, and regular physical activity and moderate alcohol consumption

Question 12

What diets help prevent hypertension?

Answer 12

Fruits, vegetables and low-fat dairy products can prevent the devellopment of hypertension

Question 13

Pharmacologic Therapy: What should a Stage I Africn American take?

Answer 13

Calcium Channel Blocker or Thiazide Diuretic

Question 14

Pharmacologic Therapy: What should a stage I non african american take?

Answer 14

ACE Inhibitor or Angiotensin Receptor Blockers

Question 15

Pharmacologic Therapy: If blood pressure is not lowered, what happens to the medications

Answer 15

Doseage is increase gradually

Question 16

Isolated systolic hypertension is associated with

Answer 16

increased risk of death, stroke, and heart failure

Question 17

Assessment: Complete history is obtained to assess for

Answer 17

other cariovascular risk factors and for signs and symptoms that indicate target organ damage

Question 18

Assessment: Maifestations of target organ damage may include

Answer 18

angina, shortness of breath, alterations in speech, vision, nosebleedsd, headaches, dizziness, or nocturia

Question 19

Potential Complications?

Answer 19

LEft Ventricular Hypertrophy
Myocardial Infarction
Heart Failure
TIA
Cerebrovacular Disease

Question 20

Major goals for the patient include

Answer 20

understanding of the disease process and its treatment

Participation in a self-care program

Absence of complications

Question 21

Increasing Knowledge: Diet Program usually consists of

Answer 21

restricting sodium and fat intake, increase intake of fruits and vegetables, and implementing regular activity

Question 22

MEdication Therapy options include

Answer 22

Diuretics, Beta-Blockers, Vasovilators, ACE Inhibitors, ARBs, and Calcium Channel Blockers

Question 23

Usually initial medication treatment is

Answer 23

thiazide diuretic

Question 24

Why might Rebound Hypertension occur?

Answer 24

Can occur if hantihypertensive medications are suddently stooped.

Question 25

Evaluation of Hypertension?

Answer 25

Reports no changes in visions

Maintains pulse rate , rhythm, and RR within normal ranges

Maintains urine output

Demonstrates no motor ,speech or sensory deficits

REports no headaches, dizziness, weakness

Question 26

Hypertensive Crises: Two classes of hypertensive crisis include

Answer 26

hypertensive emergency and hypertensive urgency (pressures about 180/120)

Question 27

What is a Hypertensive Emergency??

Answer 27

Situation where blood pressures extremely elevated and must be lowered quickly.

Question 28

Conditions associated with Hypertensive emergencies include

Answer 28

hypertension of pregnancy, acute myocardial infarction, dissecting aortic aneurysm and intracranial hemorrhage

Question 29

Hypertensive emergenices are

Answer 29

acute, life-threatening bloo pressure elevations that requirie prompt treatment in intesive care unit

Question 30

HYpertensive Emergency: Main goal is to

Answer 30

reduce blood pressure 25% in first hour

Question 31

HYpertensive Emergency: You want ot reduce it to what after six hours?

Answer 31

160/100

Question 32

HYpertensive Emergency: Exceptions are

Answer 32

Ischemic stroke and aortic disection

Question 33

HYpertensive Emergency: Medications are those that have immediate effect. This include

Answer 33

IV Vasodilators: Sodium Nitroprusside, Nicardipine, Fenoldpam Mesylate, Enalaprilat, Nitroglycerin

Question 34

HYpertensive Emergency: Nurse needs to monitor what?

Answer 34

BP and Cardiovascular Status

Question 35

HYpertensive Emergency: Blodo pressure is at what level

Answer 35

> 180/120 and must be lowered immediately to prevent damage to target organs

Question 36

Hypertensive Urgency: Described sitation in which

Answer 36

blood pressure is very elevated but there is no evidence of impending or progressive target organ damage

Question 37

Hypertensive Urgency: Elevated blood pressures associated with

Answer 37

severe headaches, nosebleeds , or anxiety

Question 38

Hypertensive Urgency: Medications that can be given are

Answer 38

Fast-acting oral agents: Beta-Adrenergic Blocker

ACE-I

Alpha 2 Agonist