Exam 2: HTN Flashcards
In HYPERtension, you are having a “blank” of the arteries which does what to blood pressure?
In HYPOtension, you are having a “blank” of the arteries which does what to blood pressure?
-HYPERtension causes a narrowing/constriction of the arteries, increasing blood pressure
-HYPOtension causes a dilation/opening of the arteries, decreasing blood pressure
HTN is known as the what?
Why is it known as that?
“Silent Killer”
Because its s/s do not show up until the effects become dangerous
What are the normal BP ranges?
-Pre-HTN?
-Stage 1 HTN?
-Stage 2 HTN?
Normal: 120/80
-Pre-HTN: 120-139/80-89
-Stage 1 HTN: 140-159/90-99
Stage 2 HTN: 160+/100+
For the effects of HTN of the organs, remember the phrase: “Can’t eat your CAKE and have it too.” Breaking CAKE down, we have:
-Cardiovascular
-brAin
Kidneys
Eyes
With this mnemonic broken down, what are some effects of HTN in each category?
-Cardiovascular: Can cause CHF
-brAin: Stroke, by weakening and narrowing the vessels, causing a clot or rupture
-Kidneys: Renal failure by weakening the arteries to the kidneys, which lowers perfusion
-Eyes: Visual changes, like blurred vision.
Primary HTN vs secondary HTN can be simplified by understanding that the cause of Primary hypertension is “blank”, and the cause of Secondary HTN is what?
-Primary HTN has an unknown cause, and you need to look at a person’s risk factors
-Secondary HTN is related to a recognized pre-existing issue
To understand the reason for a patient’s Primary HTN, we need to look at the patients what?
Risk factors
Look at the mnemonic “RISK FACTORS” and see what risk factors you can assess for in a Primary HTN patient.
Race (black men)
Increased Na+ & ETOH (alcohol)
Smoking/Stress
K+ (potassium) intake is low
Family history
Advanced age
Cholesterol >200
Too much caffeine
Obesity
Restricted activity
Sleep apnea
What are some pre-existing factors that can cause Secondary HTN?
-Pregnancy
-Cushing syndrome
-Chronic Renal Failure
-Diabetes
-Hyper/Hypothyroidism
In HTN a patient is usually asymptomatic until it is actively affecting the body. What are the “big 3” symptoms that a nurse will see in an HTN patient?
-Blurred vision
-Chest pain (angina)
-Headache
What are 3 other symptoms in HTN besides the big 3 that a patient may experience?
-Vertigo
-Tinnitus
-Epistaxis
It is the nurse’s job to assess, educate, and evaluate patients. What is an assessment method that a nurse would employ on an HTN patient’s arms?
Measure the BP in both arms, waiting 5 min in-between measurements.
When educating a client, what things would a nurse limit/eliminate the intake of in an HTN patient?
-Limit Na+
-Limit ETOH
-Limit Caffeine
-Eliminate smoking
True or False:
Typically, when a patient is newly diagnosed with HTN, pharmacological methods (Ace inhibitors, Beta-blockers, etc.) will be used to ensure a systemic therapeutic response.
False:
When a patient is NEWLY diagnosed with HTN, the patient will use non-pharmacological methods for 1-3 months before using meds.
The 1st line medications to treat HTN are ACE inhibitors, ARB’s, Calcium-Channel Blockers, and Diuretics.
The “Thiazide Diuretic” class fights HTN by what action?
Thiazide Diuretics remove water, K+, and Na+ from the kidneys and help to excrete them from the body.
This effect lowers blood volume, which lowers blood pressure.
What type of patients are Thiazides contraindicated in?
Renal Failure patients
Thiazide diuretics are still diuretics. If a patient has renal failure, they cannot excrete the Na+ and K+ that have been moved into the filtrate by the Thiazide, so it just sits in their DCT and kidneys. This results in renal pooling and will INCREASE BP as well.
What are things to educate your patient on when taking Thiazides?
Diet? Skin?
-Make sure they are eating enough K+
-Protect the skin with sunblock due to the Photosensitivity effects that Thiazides can have
