Hypertension

Question 1

Which populations higher risk of hypertension?

Answer 1

• black, south asian

* older women

Question 2

2 main factors incluending blood pressure

Answer 2

cardiac output

systemic vascular resistance

Question 3

Four main mechanisms for BP regulation

Answer 3

1. Nervous mechanism (sometimes referred to short term regulatory mechanism)
2. Renal Mechanism (sometimes referred to as long term regulatory mechanism
3. Hormonal Mechanism
4. Local Mechanisms

Question 4

Risk factors for primary hypertension

Answer 4

Obesity, high salt, genetics, sedentary lifestule, race/sex/age

• Advancing age
• Family history
• Heavy alcohol consumption
• Obesity
• Cigarette smoking
• Ethnicity
• Diabetes mellitus
• Sedentary lifestyle
• Elevated serum lipids
• Socioeconomic status
• High dietary sodium
• Psychosocial stress
• Gender

Question 5

Causes of secondary hypertension include:

Answer 5

• coarctation of the aorta or congenital narrowing of the aorta
• renal artery stenosis
• endocrine disorders such as Cushing syndrome
• cirrhosis
• neurologic disorders such as brain tumors and head injury
• sleep apnea
• pregnancy-induced hypertension

Question 6

Hypertension symptoms

Answer 6

Silent killer
-often no symptoms until something goes wrong

These symptoms include:
Fatigue
Activity intolerance
Dizziness
Palpitations
Angina
Dyspnea

common complications
• organs are especially susceptible to pressure and perfusion changes (heart, brain, kidney, eyes)

Question 7

Hypertension diagnostic tests

Answer 7

• Ambulatory blood pressure monitoring
• Urinalysis
• Blood chemistry (potassium, sodium, blood urea, and creatinine)
• Fasting blood glucose
• Fasting total cholesterol and high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides
• Standard 12-lead electrocardiography
• Assess urinary albumin excretion in clients with diabetes

Question 8

Complications of hypertension

Answer 8

• Hypertensive heart disease
> Coronary artery disease
> Left ventricular hypertrophy
> Heart failure
• Cerebro-vascular disease
• Peripheral vascular disease
• Nephrosclerosis
• Retinal damage

Question 9

Hypertension lifestyle modifications

Answer 9

Nutritional therapy
Weight reduction
Modification in alcohol consumption
Physical activity
Avoidance of tobacco products
Stress management

Question 10

Goal with hypertension

Answer 10

• achieve and maintain the target blood pressure
• reducing cardiovascular risk and target organ disease
• educate: hypertension is a chronic illness that cannot be cured but can be controlled with drug therapy, diet changes, physical activity, periodic follow-up, and relevant lifestyle modifications.

Question 11

BP cuff too small

BP cuff to large

Answer 11

BP cuff too small = high bp
BP cuff to large = low bp

If BP measurements are not equal in both arms, document this finding and use the arm with the highest BP for all future measurements.

Question 12

things to know for taking hypertension drugs

Answer 12

• Avoid hot baths, excessive amounts of alcohol, and strenuous exercise within 3 hours of taking drugs that promote vasodilation
• Recognize symptoms of orthostatic hypotension such as dizziness, lightheadedness, weakness, and blurred vision, and take steps to reduce these effects
• Supplement diet with foods high in potassium if taking potassium-wasting diuretics

Question 13

Modified lifestyle changes to make with hypertension

Answer 13

• weight reduction
• sodium reduction
• regular physical activity
• moderation of alcohol consumption
• management of psychosocial risk factors (stress and anxiety)
• avoidance of tobacco use

Question 14

The drugs currently available for treating hypertension have two main actions:

Answer 14

1) reducing systemic vascular resistance

2) decreasing the volume of circulating blood.