Exam 2, Week 5: Hypertension

Question 1

The maximum amount of force exerted against the arterial walls is:

a.) Stroke Volume
b.) Diastolic pressure
c.) Systolic pressure
d.) Blood pressure

Answer 1

c.) Systolic pressure is the maximum amount of force exerted against the arterial walls.

Question 2

If Systolic pressure is the maximum amount of force, what would Diastolic be?

Answer 2

The minimum amount of force against the arterial walls

Question 3

The peripheral resistance of cardiac output is:

a.) Systolic pressure
b.) Diastolic pressure
c.) Stroke Volume
d.) Blood pressure

Answer 3

d.) Blood pressure is the peripheral resistance of cardiac output.

Question 4

Primary (essential) Hypertension is when the blood pressure is elevated without a direct cause. How would you explain what causes primary hypertension to a patient?

How would Primary Hypertension be treated?

Answer 4

Primary Hypertension is causes are multi-factorial and don’t have one distinct trigger. It could be age related, an increase in salt to their diet, or smoking related.

Lifestyle changes and diet modifications.
-Stop smoking
-Lower sodium intake
-Medications

Question 5

If Primary Hypertension is hypertension of an unknown cause, what would Secondary Hypertension be?

How would Secondary Hypertension be treated?

Answer 5

Hypertension where the cause is identified. More often it is a direct underlying illness of affliction that causes Secondary Hypertension

Treatment depends of the cause. Secondary Hypertension is directly linked to an underlying affliction and requires medical intervention.

Question 6

Choose which superficial examples are linked to Primary Hypertension, and which are Secondary Hypertension:

-Adrenal gland disorder
-Smoking
-Age 65+
-Diabetes
-BP 140/90
-Sleep apnea

Answer 6

Adrenal, Diabetes and Sleep apnea are all Secondary because they are directly linked with a medical affliction

Smoking, age, and Bp of 140/90 are all general signs/symptoms associated with hypertension, but they are all general, and modifiable, so they are linked to Primary Hypertension.

Question 7

What receptors in the carotid sinus of the Aorta help regulate blood pressure?

a.) Chemolytic receptors
b.) Neuroreceptors
c.) Baroreceptors
d.) Aortic-Pulmonary Modifiers

Answer 7

c.) Baroreceptors in the carotid sinus of the Aorta help to regulate blood pressure.

Question 8

A nurse dealing with a hypertensive client wants to adjust the clients blood pressure. What receptors in the body would the nurse target that can sense pressure changes and change the tension of the arterial wall to adjust the clients blood pressure?

a.) Neuroreceptors
b.) Baroreceptors
c.) Aortic-Pulmonary Modifiers
d.) Chemolytic receptors

Answer 8

b.) Baroreceptors sense pressure changes, and can change the tension of the arterial wall to adjust Bp.

Question 9

Electrolytes like “X”, as well as the “Y” system also affect your blood pressure.

Answer 9

Electrolytes like Sodium, as well as the Endocrine system also affect your blood pressure

Question 10

The “Blank-Blank” system of the Kidneys, and the hormones “X” and “Y” (an ADH) of the endocrine system also affect blood pressure.

Answer 10

The Renin-Angiotensin system of the kidneys, and the hormones Aldosterone and Vasopressin affect blood pressure.

Vasopressin is an ADH. (Ant-diuretic hormone)

Question 11

List some diagnostic/Lab testing you would do on a hypertensive patient

Answer 11

-EKG
-BUN
-Creatinine
-Lipids
-K+ levels
-Sodium levels

Question 12

In situations that require alertness and energy, like facing danger, or doing physical activities, which part of the ANS mobilizes the body into action?

Answer 12

The Sympathetic NS. “Fight-or-Flight”

Question 13

What are some immediate bodily responses to the activation of the Sympathetic NS?

ex: What happens to the pupils? HR? RR? Glucose levels? What does it inhibit?

Answer 13

-Pupil dilation
-Increased BP/Cardiac Output
-Increased RR
-Releases Glucose from the Liver

-Inhibits Digestion/GI motility
-Inhibits urine production

Question 14

During ordinary, non-emergency situations, which ANS conserves and restores?

Answer 14

Parasympathetic NS. Rest and digest.

Question 15

What are some bodily responses to the activation of the Parasympathetic NS?

Answer 15

-Decreases BP/Cardiac output
-Decreased RR
-Stimulates Digestion/GI motility
-Removes waste
-Stores Glucose

Question 16

While most of the body receives a balance in signals from both the SNS and the PSNS, some bodily organs receive signals and inputs from only one system of the ANS.

What ANS exclusively controls the blood vessels of smooth muscles?

Answer 16

Sympathetic NS exclusively signals blood vessels of smooth muscles.

Question 17

What blood pressure associated illness is known as the “Silent Killer?”

Why is it called the silent killer?

Answer 17

Hypertension

There are no visible symptoms for years.

Question 18

What kind of medicine would you give a patient to relax their veins and lower their blood pressure?

a.) Acetylcholine inhibitors
b.) SSRI’s
c.) Anticholinergics
d.) ACE Inhibitors
e.) NBE Inhibitors

Answer 18

d.) ACE inhibitors stands for Angiotensin-Converting Enzyme (ACE) inhibitor.

ACE inhibitors prevent an enzyme in the body from making Angiotensin 2, which is a substance that narrows blood vessels, making them tighter and increasing pressure.

ACE inhibitors thereby dilate blood vessels through relaxation, lowering their blood pressure.

Question 19

Beta-blockers are a type of drug that may be prescribed to treat hypertension in patients. Beta-blockers get their name because they act as antagonists and block adrenergic beta-receptors, so that certain hormones that COULD elevate the HR do not work.

What are the 2 hormones that Beta-blockers…“block” that both elevate the heart rate, and make it beat with more force?

By blocking these hormones, beta-blockers do what to your HR and Blood pressure?

Answer 19

Beta-blockers block the hormones “Adrenaline” and “Noradrenaline”

By Blocking Adrenaline and Noradrenaline, this lowers your HR and blood pressure

Question 20

A patient is at risk for hypertension. It is recognized that he is retaining too much bodily fluids, specifically Na+ and H2O. What drug class could be given to reduce the volume of liquid, and thus the volume of blood circulating?

How would this drug help in this way?

Answer 20

Diuretic(s)

Diuretics reduce the amount of bodily fluid retention by lowering Na+ and H2O levels through nephron (kidney) activation. This increases the volume of urine to be excreted. After excretion, the fluid levels go down, which also decreases overall blood volume, decreasing BP.

Simply put: Diuretics help piss away Hypertension by lowering blood volume through urinating body fluids.

Question 21

Since diuretics are used to lower blood pressure, and have an effect of the kidneys, it is safe to say that drugs that work with the kidneys help to lower BP to fight hypertension. With that in mind, what other drug class would help fight hypertension?

a.) Renin-Inhibitors
b.) Antidiuretics
c.) Anticonvulsants
d.) ADP inhibitors

Answer 21

a.) Renin-inhibitors work with the renin-angiotensin system of the kidneys

Question 22

What electrolyte plays a huge role in cardiac contractions?

If it is reduced or blocked, what effect will it have?

Because of their big interaction with contractions in the heart, what drug type could be useful in treating a hypertensive client?

Answer 22

Calcium plays a huge role in contractions, particularly in coronary and peripheral arteries.

If Calcium levels are reduced, it will result in dilation of arteries.

So, Calcium-channel blockers would be effective in Hypertension drug treatment.

Question 23

What type of diuretics can cause dehydration and orthostatic hypotension?

Answer 23

Loop Diuretics can cause dehydration and orthostatic hypotension

Question 24

Patients taking antihypertensive drugs need proper education from their nurses to ensure their safety. What are examples of teaching that a nurse should give her patients who are on hypertensive drug therapy?

ex: What would a loop diuretic do? What would a vasodilator do to BP? What does this mean for a patients ADL?

Answer 24

-Loop diuretics can cause dehydration and orthostatic hypotension
-Change positions in your bed slowly to avoid dizziness
-Vasodilators cause a change in BP when you change positions
-Do not suddenly stop taking your meds. This could cause Angina, an MI or rebound Hypertension.
-

Question 25

The quality of blood flow depends on 3 factors:

1.) The “blank” of the heart pump
2.) The “blank” of the blood vessels
3.) The “blank” and “blank” of the blood.

Answer 25

1.) The Efficiency of the heart pump

2.) The Patency of the blood vessels
(Is there Hypertension or clogged arteries?)

3.) The Quality and Quantity of the blood
(Is the blood thick? Is it anemic?)

Question 26

“Third-spacing” is otherwise known as a what?

Answer 26

An Edema

Question 27

What is the issue that is causing third spacing?

Answer 27

There is too much circulatory fluid that is causing pressure, and it is not leaving.

Question 28

The thin-walled, permiable network that rids the body of excess toxins and waste is known as the “X” system.

Answer 28

The Lymphatic system a thin-walled, permiable network that rids the body of toxins and waste.

Question 29

Aspects of the vascular system that carry blood from the heart are the “X.”

Aspects of the vascular system that carry blood to the heart are the “Y.”

Answer 29

Arteries and arterioles carry blood FROM the heart.

Veins and Venules carry blood TO the heart.

Question 30

How many layers do arteries have?

Answer 30

3:

Intima, which is endothelial tissue.
Media, which is smooth muscle.
Adventitia, which is CT.

Luckily their names give away their order from innermost to outermost.

Question 31

What part of the vascular system connects to form venules, which then become veins?

Answer 31

Capillaries connect to become venules.

Question 32

If a vessel fails to “X” when its needed, that’s when Ischemia happens.

Answer 32

If a vessel fails to “dilate” when it is needed, that’s when ischemia happens.

Question 33

Capillary Filtration involves fluid exchange across the capillary membrane walls. Looking at the words “Capillary Filtration”, we have everything we need to know about how it works. Specifically, because of “Filtration.”

What does filtration involve?

If the “Filtration” in Capillary Filtration is high, what does that mean?

Therefore, if Capillary Filtration is high, what does that mean for capillary permeability for fluid exchange?

Answer 33

Filtration involves pressure to facilitate movement

If Filtration is high, that means that Pressure is high

Therefore, if Capillary Filtration is high, which means the pressure is high-and pressure is needed to facilitate movement in filtration-that means that permeability is high as well. This allows for better fluid exchange in the capillaries.

Question 34

When Capillary Filtration is high, there is greater permeability in fluid exchange. Because of this, what is a possible adverse effect of this high permeability of fluid exchange?

Answer 34

Third spacing

Question 35

Hemodynamic resistance basically means that blood flow will depend on resistance given by either the dilation or relaxation of a blood vessel.

So, if a vessel is narrow, i.e. constricted, will its Hemodynamic resistance be greater or lesser?

What about if the vessel was dilated?

Answer 35

A narrow vessel will have increased Hemodynamic resistance.

An expanded/dilated blood vessel will have decreased Hemodynamic resistance.