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N160 exam 3 > HTN and HF > Flashcards

HTN and HF Flashcards

1
Q

What is hypertension?

A
  • A sustained elevation of BP.

- A sign that the heart and blood vessels are being overworked.

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2
Q

What is a normal BP?

A

Systolic: less than 120
Diastolic: less than 80

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3
Q

What will be the result if high blood pressure is untreated?

A
  • Atherosclerosis
  • Congestive Heart Failure
  • Organ damage
  • Cardiomyopathy
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4
Q

How is BP determined?

A
  • Cardiac Output (stroke volume x heart rate)

- Peripheral Resistance

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5
Q

What are the regulatory mechanisms for BP?

A
  • Arterial baroreceptors
  • Renal regulation of body fluid volume
  • Renin-angiotensin-aldosterone system
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6
Q

What is the function of arterial baroreceptors?

A

Monitor the level of arterial pressure in:

  • Carotid sinus
  • Aortic arch
  • Left ventricle

The arterial baroreceptors found in the aorta & left ventricle monitor the level of arterial pressure & vasodilation.

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7
Q

How does the renal system regulate the body fluid volume?

A

Excess salt & water changes venous return to the heart causing rise in CO (Cardiac Output), especially if the pt has poor kidney function

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8
Q

What is the function of renin, angiotensin, and angiotensin II?

A

They are vasoconstrictors that inhibit release of salt excretion from the kidneys.

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9
Q

Name the modifiable risk factors for HTN:

A
  • Tobacco use
  • Dyslipidemia (LDL)
  • Excess dietary sodium (decrease intake)
  • Obesity (lose at least 5lbs)
  • Sedentary lifestyle
  • Alcohol use
  • High caffeine intake (stimulant; boost HTN)
  • Stress
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10
Q

Name the non-modifiable risk factors for HTN:

A
  • Age: 50% of ppl over 60 have HTN
  • Ethnicity: 2x more prevalent in AA’s
  • Gender: Men under 55 yrs; Women over 55 yrs
  • Family history
  • Socio-economic status
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11
Q

What is HTN also known as?

A

The silent killer

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12
Q

What are the two major classifications of HTN?

A
  • Essential or Primary (idiopathic) Hypertension

- Secondary Hypertension

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13
Q

How does Essential or Primary (idiopathic) HTN begin?

A
  • It has no known cause

- Begins as a benign disease and progresses

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14
Q

What are the associated risk factors with Essential or Primary (idiopathic) HTN?

A
  • Family history, age, race
  • High sodium intake
  • Physical inactivity
  • Excessive alcohol intake / smoking / drugs
  • Low potassium, calcium, magnesium intake
  • Excessive calorie consumption, obesity
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15
Q

How does secondary HTN begin?

A

It’s related to a specific disease

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16
Q

What specific diseases can cause secondary HTN?

A
  • Renal disease
  • Coronary artery disease
  • Dysfunction of adrenal glands
  • Neurogenic disease; brain tumors, encephalitis
  • Pregnancy
  • Medications: estrogens + oral contraceptives
  • Psychiatric disorders
17
Q

What is benign primary hypertension?

A
  • Usually has no symptoms
  • Has an elevated BP (140-150/90-99)
  • Early signs: palpations + headache
18
Q

What is resistant hypertension?

A

High BP that is under control, but requires for or more meds that are also considered resistant.

19
Q

How does resistant hypertension occur?

A
  • Occurs if the pt’s BP remains above goal

- BP still resistant when taking 3 meds from different antihypertensive categories.

20
Q

What is accelerated hypertension?

A

When the BP has increased over a short period of time

21
Q

What are the symptomatic vascular changes associated with accelerated hypertension?

A
  • Heart attack
  • Epistaxis
  • Hematuria
  • Proteinuria
  • Angina
22
Q

What is malignant hypertension?

A
  • Rapid, progressive severe vascular changes
  • BP readings of SBP > 200 mmHg, DBP > 150 mmHg
  • Needs RAPID intervention
23
Q

What symptoms are associated with malignant hypertension?

A
  • Morning headaches
  • blurred vision
  • dyspnea
  • uremia
24
Q

What progressive systemic complications are associated with malignant hypertension?

A
  • Renal failure
  • L. Ventricular failure
  • End-stage renal disease
  • CVA (cerebrovascular accident aka stroke)
  • MI (myocardial infarction aka heart attack)
25
Q

What are the two types of hypertensive crisis?

A

Hypertensive urgency and hypertensive emergency

26
Q

What is a hypertensive urgency?

A

When the BP is elevated, but no sign of organ damage.

27
Q

What are the s/s of hypertensive urgency?

A
  • Severe headaches
  • Nose bleeds
  • Anxiety
28
Q

How should you treat hypertensive urgency?

A
  • Oral beta-blocker agents
  • Angiotensin inhibitors
  • Alpha-blockers
29
Q

What BP is considered a hypertensive emergency?

A

-BP 180/120 mmHg or higher

30
Q

What are the s/s of a hypertensive crisis?

A
  • Nausea
  • Vomiting
  • Severe headache
  • Diuresis
  • Change in LOC
  • Seizures
  • Coma
  • Blurred vision
  • Numbness/tingling in limbs
31
Q

Why does BP need to be lowered in a hypertensive emergency?

A
  • BP must be lowered immediately to prevent organ damage

- Admit to critical care units

32
Q

What medications should be used to treat hypertensive emergencies?

A
  • sodium nitroprusside (Nipride, Nitropress)
  • nicardipine hydrochloride (Cardene)
  • fenoldopam mesylate (Corlopam)
  • enalapril (Vasotec)
  • nitroglycerin (Nitro-Bid, Tridil)
33
Q

How should you treat a hypertensive emergency?

A
  • Reduce mean arterial pressure (MAP) 25% in 1st hr

- If pt is stable decrease BP to 160/100-110 over the next 2-6 hrs.

34
Q

What are the cardiac complications associated with HTN?

A

-Coronary artery disease
-Left ventricular hypertrophy
-Angina
-Heart failure
-MI (myocardial infarction)
Pulmonary edema

35
Q

What are the cerebro vascular complications associated with HTN?

A
  • Transient ischemic attack (TIA)

- Stroke (CVA)

36
Q

What are the peripheral vascular complications associated with HTN?

A
  • Absence of peripheral pulses
  • Intermittent claudication- possible
  • Aneurysm
37
Q

What are the renal complications associated with HTN?

A
  • Elevated serum creatinine (1.5 mg/dl)
  • Proteinuria (1+ or greater)
  • Micro albuminuria
  • Chronic renal failure (CRF)
  • End-stage renal disease (ESRD)
38
Q

What are the retinopathy complications associated with HTN?

A

Retinal hemorrhages

N160 exam 3 (7 decks)

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