HTN (Module 4) Flashcards
BP
strength of blood pushing against the sides of the arteries
influenced by CO and systemic peripheral vascular resistance (PVR)
BP Regulation
maintained by the ANS
stimulation of the SNS causes tachy, increase contractility and BP (RAAS)…fight or flight response
HTN
average BP that is higher than normal over a period of time (2+ office visits)
SILENT KILLER; USUALLY ASYMPTOMATIC
MAP
average arterial pressure during a cardiac cycle (indicator of organ perfusion pressure)
> 60 mmHg is enough to sustain organs
<60 mmHg organs aren’t perfused and will eventually become ischemic
Pulse Pressure (SBP-DBP)
indicates the health and tone of arterial walls
stroke volume affects pulse pressure
Narrowed Pulse Pressure (<40)
poor heart function
lower stroke volume
HF
hypovolemia/bleeding
aortic stenosis
mitral stenosis
regurg
Widened/Increased Pulse Pressure (>60)
cardiovascular disease
slow HR
aortic regurgitation
atherosclerosis
HTN
aging
OH
decrease in BP by 20 mmHg systolic and 10 mmHg diastolic
S3 Heart Sound “Kentucky”
ventricular gallop after S2
normal in elderly, pregnant, adolescents, athletes
SYSTOLIC HEART FAILURE
S4 Heart Sound “Tennessee”
atrial gallop before S1
almost always pathological (might be OK in healthy older adults)
stiff ventricle, diastolic dysfunction
left ventricular hypertrophy (LVH)
Primary HTN
chronic elevation in BP that occurs w/o disease
can be diastolic, systolic or both
results in damage to vital organs and thickening of arterioles
Primary HTN Risk Factors
family history
AA ethnicity
hyperlipidemia
smoking
>60 yo or postmenopausal
excessive sodium/caffeine intake
overweight/obesity
physical inactivity
excessive alcohol intake
low K, Ca, or Mg intake
excessive and continuous stress
Secondary HTN
high BP that results from some other disorder
Secondary HTN Risk Factors
kidney disease
primary aldosteronism
pheochromocytoma
cushing’s
coarctation of the aorta
brain tumors
encephalitis
pregnancy
drugs (estrogen, glucocorticoids, mineralcorticoids, sympathomimetics)
HTN Diagnostics and Labs
serial BP readings
cholesterol lvls
microalbuminuria (small amounts of protein in urine aka kidney damage)
Garlic and Coenzyme Q10 ADE (HTN)
bleeding and liver damage
ACEi and ARB
angioedema (allergic reaction!)
assess for hyperkalemia
hold for SBP <100
BB
hold for HR <50-60 bpm
hold for SBP <90-100
CCB
NO GRAPEFRUIT JUICE
Diuretics
daily weights important for tracking!
assess for dehydration and electrolyte imbalance
Loop and Thiazide Diuretics SE
HYPOkalemia (life threatening dysrhythmias)
HYPOmg
eat foods high in K
K Sparing Diuretics SE
HYPERkalemia (life threatening dysrhythmias)
weakness
irregular pulse
avoid foods high in K
HTN Nursing Care
commitment to long term therapy is the most importantly goal for someone with HTN
INDIVIDUALIZE PLAN
BP Trackers
prepare (no coffee/smoking, empty bladder, sit awhile, no anxiety or exercise)
BP in both arms, relax before testing, single BP is useless (white coat phenomenon)
Salt Reduction Education
reduce salt added when preparing foods; avoid/limit consumption of high salt foods like soy sauce, fast foods, and processed foods
no more than 2400 mg/day, limit to 1500 mg/day
Healthy Diet
reducing food high in sugar, saturated fat, trans fat such as DASH diet
increase veggies high in nitrates known to reduce BP like leafy veggies and beetroot
high in Mg, Ca, K
Healthy Drinks
mod consumption of coffee, green and black tea
hibiscus tea, pomegranate juice, beetroot juice and cocoa
Moderate of Alcohol Consumption
2 standard drinks for men and 1.5 for women; no binge drinking
Weight Reduction
ethnic-specific cut offs for BMI and waist circumference
waist-to-height ratio <0.5 is recommended; measure at level of belly button
Regular Physical Activity
moderate intensity aerobic exercise for 30 min on 5-7 days a week or HIIT
strength training 2-3 days a week
Reduce Exposure to Air Pollution/Col Temps
negative effect of air pollution on BP in long term
