Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg 1 > Exam 2- Assessment & Management of Patients with Hypertension > Flashcards

Exam 2- Assessment & Management of Patients with Hypertension Flashcards

1
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Prevalence of HTN: Highest rate and what percentage

A

Greater than or equal to 65 years of age (69.7%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Prevalence of HTN: Non-Hispanic blacks percentage

A

38.6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Of those with HTN, prevalence with pharmacological treatment percentage

A

69.9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prevalence of Treatment: Lowest among what age group and what percentage?

A

18-39 years
37.4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prevalence of Treatment: Mexican Americans percentage

A

56.1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Prevalence of Treatment: Those without a source of medical care

A

19.8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Prevalence of Treatment: Those who had received medical care less than twice during previous year

A

33.8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Prevalence of Treatment: Those without healthcare insurance

A

43.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HTN: Normal Systolic and Diastolic

A

Systolic: Less than 120
Diastolic: Less than 80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Prehypertensive Systolic and Diastolic

A

Systolic: 120-139
Diastolic: 80-89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Stage 1 HTN Systolic and Diastolic

A

Systolic: 140-159
Diastolic: 90-99

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Stage 2 HTN Systolic and Diastolic

A

Systolic: Greater than or equal to 160
Diastolic: Greater than or equal to 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hypertensive Crisis: Systolic and Diastolic
What do you do?

A

Systolic: higher than 180
Diastolic: higher than 120
Consult your doctor immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

HTN is based on what?

A

The average of two or more accurate BP measurements taken 1-4 weeks apart by a HC provider

29
Q

Primary Hypertension

A

High blood pressure from an undetermined cause

30
Q

Secondary Hypertension

A

High blood pressure with an identifiable cause

31
Q

Examples of Secondary Hypertension (6)

A
  • Renal parenchymal disease
  • Hyperaldosteronism
  • Medications (prednisone, epoetin)
  • Coarctation of the aorta
  • Pregnancy
  • Sleep apnea
32
Q

HTN Risk Factors (9)

A
  • Ethnicity (especially African American)
  • Obesity
  • Age
  • Genetics (family history)
  • Diet
  • Sedentary lifestyle
  • ETOH Consumption
  • Smoking (also increased for those with CV conditions, including HF, CAD, and HX of stroke)
  • Obstructive Sleep Apnea
33
Q

HTN Clinical Manifestations: Symptomatic or Asymptomatic?

A

Asymptomatic (“silent killer”)

34
Q

HTN Clinical Manifestations: When specific S/S occur, typically indicative of…

A

Vascular damage with manifestations related to organs served by involved vessels

35
Q

HTN Clinical Manifestations Examples

A
  • Retinal damage or other eye changes
  • Renal damage
  • MI
  • Heart failure
  • Cardiac hypertrophy (Left Ventricular)
  • Stroke
  • Peripheral arterial disease
36
Q

Assessment & Diagnostics (5)

A
  • History and physical examination
  • Laboratory Studies
  • 12 Lead ECG
  • 2D Echo
  • Risk Factor Assessment for CVD
37
Q

What lab studies do we do for HTN?

A
  • Blood Chemistry (NA, K, fasting glucose)
  • BUN/CR
  • Urinalysis
  • Total and HDL cholesterol levels
38
Q

Risk Factors for CVD in Patients with Hypertension (8)

A
  • Smoking
  • Obesity
  • Diabetes
  • Physical Inactivity
  • Impaired Renal Function (GFR less than 60mL/min)
  • Age (greater than 55 for men, greater than 65 or women)
  • Family history of CVD
  • Dyslipidemia (elevated LDL, or total cholesterol and/or low HDL)
39
Q

Medical Management for HTN: Goal maintained BP

A

140/90 mmHg or lower

40
Q

Medical Management for HTN: Goal maintained BP for patients older than 60

A

150/90 mmHg

41
Q

What does a maintained goal BP allow for?

A

Clinical judgement and individual patient considerations

42
Q

Medical Management HTN: Treatment

A

Optimal treatment plan is inexpensive, simple, and least disruptive

43
Q

Medical Management for HTN: Lifestyle Modifications (4)

A
  • Weight loss
  • DASH diet
  • Physical activity
  • Moderate alcohol consumption
44
Q

Medical Management for HTN

A
  • Pharmacological Treatment
45
Q

What is the Pharmacological Treatment used for?

A

To decrease peripheral resistance, blood volume, or the strength and rate of myocardial contraction

46
Q

Initial medications (for those with uncomplicated HTN)

A
  • ACE or ARB
  • Diuretics
  • Beta Blockers
  • Combination
47
Q

How does dosing work for initial medications with HTN?

A

Doses increased gradually until target BP met
- Additional medications added as necessary to achieve control

48
Q

Why is the simplest treatment schedule used for HTN?

A

To promote adherence (ideally one pill per day)

49
Q

Controlling high BP may benefit from a ___, between HC systems, HC providers, and patients working together

A

Team-Based Approach

50
Q

Nursing Care & Management for HTN. What does this include?

A
  • History and physical assessment
    Include:
  • Assessment of risk factors
  • Accurate BP measurement
  • Assessment of impact of HTN on body and other personal, social, or financial factors
51
Q

Nursing Diagnoses for HTN (2)

A
  • Deficient knowledge regarding the relation between the treatment regimen and control of the disease process
  • Noncompliance with therapeutic regimen related to side effects of prescribed therapy
52
Q

Collaborative Problems for HTN (7)

A
  • Left ventricular hypertrophy
  • Myocardial infarction
  • TIA
  • Heart failure
  • Stroke
  • Renal insufficiency or failure
  • Retinal hemorrhage
53
Q

Planning & Goals for HTN (3)

A
  • Understanding disease process and treatment
  • Participation in a self care program
  • Absence of complications
54
Q

Nursing Interventions for HTN (5)

A
  • Promotion of adherence to treatment regimen (compromises may be necessary, support pt’s making even small changes, and support groups)
  • Education
  • Consultation with collaborative team (Dietician)
  • Follow up care
  • Emphasis on life long process and changes
55
Q

Evaluation for HTN

A
  • Reports knowledge of disease management sufficient to maintain adequate tissue perfusion
  • Adheres to the self-care program
  • Absence of Complications
56
Q

Gerontologic Considerations for HTN

A
  • Medication regimen can be difficult to remember
  • Expense can be a challenge
  • Monotherapy
  • Ensure that older adult patients understand the regimen and can see and read instructions, open medication containers, and get prescriptions refilled
  • Include family and caregivers in educational program
57
Q

Evaluation for HTN: Reports knowledge of disease management sufficient to maintain adequate tissue perfusion (examples)

A
  • Maintains BP at less than 140/90 mmHg with no symptoms of angina, palpitations, or vision changes
  • Stable BUN and serum creatinine levels
  • Palpable peripheral pulses
58
Q

Evaluation for HTN: Adheres to the self-care program (exmaples)

A
  • Reduces calorie, Na, and fat intake
  • Exercises regularly
  • Takes medications as prescribed and reports side effects
  • Measures BP
  • Abstains from tobacco and excessive alcohol intake
  • Keeps appointments
59
Q

Gerontologic Considerations for HTN: Monotherapy

A

If appropriate, may simplify the medication regimen and make it less expensive

60
Q

Gerontologic Considerations for HTN: Medication regimen can be difficult to remember

A
  • May predispose to orthostatic hypotension
  • May also be more sensitive to volume depletion from diuretic therapy
61
Q

Hypertension signs and symptoms: ABC

A

Achy head
Blurred vision (retinopathy)
Chest pain (angina)

62
Q

BP over 180/120: BCDE

A

Immediate IV drugs
Beta blockers (B- blocks beats)
CCBs (C- calms the heart)
Dilators (Vasodilators) (Nitro = pillow)

63
Q

HTN Causes: SODA

A
  • Stress, Smoking, Seditary Lifestyle
  • Obesity, Oral contraceptives (BC)
  • Diet (High sodium & Cholesterol), Diseases (DR. HH) (DM, Renal Disease, HF, Hyperlipidemia)
  • African men & Age (old)
64
Q

HTN Treatments: DRESS

A
  • Diet: low SCC (sodium, calories, cholesterol)
  • Reduce alcohol & caffeine
  • Exercise: Walking (30 min x 5 days/week)
  • Stop smoking & alcohol
  • Stress reduction
65
Q

HTN Risk Factors that can’t be changed (3)

A
  • increasing age
  • male gender
  • heredity (including race)
66
Q

HTN Risk Factors that you CAN change (6) & Other Factors to consider

A
  • tobacco smoke and vaping
  • high blood cholesterol
  • high BP
  • physical inactivity
  • obesity and being overweight
  • diabetes
    Other factors to consider:
    Stress, sleep, alcohol, and diet/nutrition
67
Q

For patients with uncomplicated, hypertension, and no specific indicators for another medication, what is the initial medication?

A

Thiazide diuretic, like hydrochlorothiazide

68
Q

The nurse is preparing an education plan for a patient newly diagnosed with hypertension. What should be included in the education plan?

A

Engage in regular aerobic physical activity such as brisk walking (at least 30 mins/day most days of the week)

69
Q

An 84 year old male newly diagnosed with primary hypertension, has just been started on a beta-blocker. Your nursing education for this patient should include, what?

A

Use of strategies to prevent falls stemming from postural hypotension

Med Surg 1 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions