Exam 2 - HTN Flashcards
main risk factor for CAD
HTN
most common chronic disease among US adults
HTN
how is it determined an individual has HTN
SBP > 140 or DBP >90 based on an average of 2 or more accurate BP measurements taken 1-4 weeks apart
HTN is aka
the silent killer
which race has the highest prevalence of HTN
African Americans
cause of primary HTN
idiopathic
95% of pts
cause of secondary HTN
renal disease
sleep apnea
pregnancy related
–secondary d/t an another underlying issue
symptoms r/t organ damange
retinal, other eyes changes renal damage MI cardiac hypertrophy stroke, TIA
HTN risk factors
alcohol gender smoking obesity physical inactivity dyslipidemia DM CKD/impaired renal function older age family hx
how many alcoholic drinks are okay daily for men and for women?
m: 2
w: 1
medical management BP range for an individual with HTN
< 130/80
lifestyle modification for HTN
weight loss
DASH diet, decrease Na intake
regular physical activity
reduce alcohol comsumption
stage 1 HTN drug classes of choice for African Americans and pts > 60 y/o
CCB
thiazide diuretics
stage 1 HTN drug classes of choice for non-African Americans and pts < 60 y/o
ACE-I
ARB
will pts be started on a low or high dose of BP med initially?
low, increase gradually if needed
when is it considered resistant HTN?
UNCONTROLLED with 3 different types of BP meds (including diuretics)
*controlled with 4
potential complications of HTN
L ventricular hypertrophy MI HF TIA CVA, stroke, brain attack renal insufficiency/CKD retinal hemorrhage
gerontologic considerations
med regimen can be difficult to remember expenses comprehension include family, caregivers monotherapy
when BP increases so the risk for…
MI
HF
stroke
renal disease
HTN is a ___ ___ ___ ___ identified in Healthy People 2020.
high priority health concern
83% of people over the age of ___ are aware they have high BP
20
HTN crisis is divided into which 2 categories?
urgency
emergency
BP reading for HTN urgency
> 180/110
is HTN urgency quick acting?
develops over hours to days
meds to tx HTN urgency
catapres
capoten
normodyne
HTN emergency BP reading
> 220/140
is there target organ damage with urgency or emergency?
emergency
what are some causes of HTN emergency?
noncompliance with meds
under-medicated
what are some problems that can occur during a HTN crisis?
encephalopathy intracranial, subarachnoid hemorrhage HF MI renal damage dissection aortic aneurysm retinopathy
s/sx of HTN emergency
HA
N/V
syndrome in which a sudden rise in BP is associated with HA, N/V, seizures, confusion, coma are the results of increased cerebral capillary permeability
HTN encephalopathy
s/sx of cardiac decompensation
unstable angina MI HF pulmonary edema can have chest pain, dyspnea
s/sx of aortic dissection
sudden, excruciating chest, back pain
possibly reduced or absent pulses in the extremities
how much do you want to try to reduce the SBP during a HTN crisis within the first hour?
< 25%
*MAP 20-25% or 110-115mmHg
how much do you want to try to reduce the SBP during a HTN crisis within hours 2-6?
160/110
when should BP be controlled after initiating tx’ment for HTN crisis
24-48 hours
IV anti-HTN drugs titrated to MAP or BP
Vasodilators -nicardipine (CCB); sodium nitroprusside Adrenergic Inhibitors -Phentolmine; labetalol (A+B blocker) ACE-I -Enalapril
