Exam 2; Hypertension

Question 1

blood pressure

Answer 1

force exerted by the blood against the walls of the blood vessel

it is the fxn of CO & systemic vascular resistance

Question 2

cardiac output

Answer 2

total blood flow pumped through the circulation per min

Question 3

systemic vascular resistence

Answer 3

force opposing the mvmt of blood within the vessels

Question 4

blood pressure is

Answer 4

cardiac output x systemic vascular resistance

Question 5

hypertension classifications

Answer 5

normal= <120 or < 80 diastole
prehypertension= 120-139 or 80-89 diastole
hypertension stage 1= 140-159 or 90-99 diastole
hypertension stage 2= >160 or >100 diastole

Question 6

primary hypertension

Answer 6

essential or idiopathic hypertension… elevated bp without any cause
makes up the majority of htn cases

Question 7

secondary htn

Answer 7

elevated bp with a specific cause
smaller percentage of population
trtmt aimed at removing or treating cause

Question 8

physiological factors impacting htn

Answer 8

altered renin-angiotensin-aldosterone system
- increase renin activates RAAS
- renin levels do not decrease in response to elevated BP

Question 9

endothelial dysfunction

Answer 9

-impaired response to nitric oxide vasodilation
- elevated endothelin–> vasoconstriction

Question 10

risk factors for primary hypertension

Answer 10

age, gender, alcohol, tobacco use, diabetes, excess sodium, family history, obesity, ethnicity, stress

Question 11

factors influencing secondary hypertension

Answer 11

vascular disease
renal disease
endocrine disorders
neurologic disorders
liver disorders
sleep apnea
pregnancy
meds

Question 12

clinical manifestations

Answer 12

“silent killer”
HA, dyspnea, anxiety, nosebleeds

Question 13

htn complications

Answer 13

can effect:
eyes
heart
brain
kidneys

Question 14

htn diagnostic studies

Answer 14

urinalysis
BUN and serum creatinine
creatinine clearance
serum electrolytes
ECG
uric acid levels
echocardiogram

Question 15

htn inter-professional care

Answer 15

goal is to control BP & reduce CVD risk factors and target organ disease

Question 16

diuretics

Answer 16

decrease fluid volume

Question 17

beta-adrenergic blockers

Answer 17

blocks sympathetic stimulation and decreases CO

Question 18

vasodilators

Answer 18

relaxes smooth mm of arterioles & decreases peripheral vascular resistance

Question 19

calcium channel blockers

Answer 19

increase sodium excretion and causes arteriolar vasodilation by preventing the movement of extracellular ca into cells

Question 20

ACE inhibitors

Answer 20

prevents the conversion of angiotensin I to angiotension II, which prevents vasoconstriction and sodium and water retention

Question 21

ARBs

Answer 21

prevents angiostensin II from binding to its receptors in the walls of the blood vessels

Question 22

htn pt teaching

Answer 22

follow-up care
identify, report and minimize side effects
-orthostatic hypotension
- sexual dysfunction
- dry mouth
- frequent urination
- time of day to take drug

Question 23

goals/ outcomes of drug therapy

Answer 23

in pt > 60, start drug treatment for BP > 150 mm Hg or >90 mm Hg diastolic & treat to goal BP less than those thresholds

Question 24

drug therapy

Answer 24

in pt younger than 60, treatment & initiation goal should be 140/90 mm Hg

Question 25

resistant htn

Answer 25

failure to reach goal BP in patients taking full dose of an appropriate 3-drug therapy regimen that includes a diuretic

Question 26

htn nursing assessment subjective data

Answer 26

past health history
hypertension
cv, cerebrovasular, renal, thyroid disease
diabetes, pituitary disorders, obesity
family history
salt and fat intake
family history
weight gain or loss
stressful events
blurred vision

Question 27

htn objective data

Answer 27

blood pressure readings
heart sounds
pulses
edema
body measurements
mental status changes

Question 28

HTN nursing diagnosis

Answer 28

altered blood pressure
ineffective tissue perfusion
impaired sexual dysfunction
potential complications: stroke, MI, renal failure

Question 29

HTN nursing planning (outcomes identification)

Answer 29

pt will achieve & maintain goal BP, experience minimal side effects of therapy & manage and cope with the condition

Question 30

HTN nursing implementation (health promotion)

Answer 30

lifestyle modification
individual pt eval and edu
screening programs
CV risk factor modification

Question 31

HTN nursing implementation (ambulatory care)

Answer 31

evaluate therapeutic effectiveness
detect and report adverse effects
assess and enhance compliance
pt and caregiver teaching

Question 32

hypertensive crisis

Answer 32

systolic BP greater than 180 or diastolic BP greater than 120

emergency= evidence of target organ damage
urgency= no evidence of target organ damage
usually occurs in ppl with chronic HTN