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

1
Q

Hypertension defined by

A

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

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2
Q

What is Prehypertension

A

120-139/80-89

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3
Q

What is Stage 1 Hypetension

A

140-159 / 90-99

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4
Q

What is Stage 2 Hypertension

A

> 160 - > 100

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5
Q

95% of patients with high blood pressure have

A

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

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6
Q

Remaining 5% of patients with high blood presure have

A

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

This includes chronic kidney didsease, renal artery stenosis, hyperaldosteronism

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7
Q

When signs eventually appear , they usually indicate

A

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

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8
Q

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

A

Hyperthrophy occurs.

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9
Q

Lab studies include

A

Urinalysis

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

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10
Q

Renal damage may be suggsted by

A

elevations in BUN and Creatinine levels

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11
Q

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

A

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

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12
Q

What diets help prevent hypertension?

A

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

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13
Q

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

A

Calcium Channel Blocker or Thiazide Diuretic

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14
Q

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

A

ACE Inhibitor or Angiotensin Receptor Blockers

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15
Q

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

A

Doseage is increase gradually

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16
Q

Isolated systolic hypertension is associated with

A

increased risk of death, stroke, and heart failure

17
Q

Assessment: Complete history is obtained to assess for

A

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

18
Q

Assessment: Maifestations of target organ damage may include

A

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

19
Q

Potential Complications?

A
LEft Ventricular Hypertrophy
Myocardial Infarction
Heart Failure
TIA
Cerebrovacular Disease
20
Q

Major goals for the patient include

A

understanding of the disease process and its treatment

Participation in a self-care program

Absence of complications

21
Q

Increasing Knowledge: Diet Program usually consists of

A

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

22
Q

MEdication Therapy options include

A

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

23
Q

Usually initial medication treatment is

A

thiazide diuretic

24
Q

Why might Rebound Hypertension occur?

A

Can occur if hantihypertensive medications are suddently stooped.

25
Q

Evaluation of Hypertension?

A

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

26
Q

Hypertensive Crises: Two classes of hypertensive crisis include

A

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

27
Q

What is a Hypertensive Emergency??

A

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

28
Q

Conditions associated with Hypertensive emergencies include

A

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

29
Q

Hypertensive emergenices are

A

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

30
Q

HYpertensive Emergency: Main goal is to

A

reduce blood pressure 25% in first hour

31
Q

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

A

160/100

32
Q

HYpertensive Emergency: Exceptions are

A

Ischemic stroke and aortic disection

33
Q

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

A

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

34
Q

HYpertensive Emergency: Nurse needs to monitor what?

A

BP and Cardiovascular Status

35
Q

HYpertensive Emergency: Blodo pressure is at what level

A

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

36
Q

Hypertensive Urgency: Described sitation in which

A

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

37
Q

Hypertensive Urgency: Elevated blood pressures associated with

A

severe headaches, nosebleeds , or anxiety

38
Q

Hypertensive Urgency: Medications that can be given are

A

Fast-acting oral agents: Beta-Adrenergic Blocker

ACE-I

Alpha 2 Agonist