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Adult Health I > Hypertension > Flashcards

Hypertension Flashcards

1
Q

risk factors of hypertension

A
  • smoking
  • obesity
  • poor diet
  • stress
  • sedentary lifestyle
  • male gender
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2
Q

clinical manifestation of hypertension

A
  • fatigue
  • dizziness
  • headache
  • palpitations
  • dyspnea
  • chest pain – angina
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3
Q

causes of hypertension

A
  • primary = unknown
  • secondary = specific cause
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4
Q

complications of hypertension

A
  • atherosclerosis/CAD
  • left ventricular hypertrophy
  • heart failure
  • stroke/TIA
  • hypertensive encephalopathy
  • peripheral vascular disease
  • nephrosclerosis
  • retinopathy/retinal hemorrhage
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5
Q

labs and diagnostics for hypertension

A
  • lipid panel
  • urinalysis
  • CBC
  • BMP
  • liver function
  • EKG/ECG
  • echocardiogram
  • serum uric acid Ca/Mg
  • TSH levels
  • eye exams
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6
Q

goals for hypertension

A
  • achieve and maintain goal BP
  • reduce CV risk factors and target organ disease
  • lifestyle modifications = exercise, manage BP, manage cholesterol, decrease blood sugar, better diet, stop smoking
  • lose weight – DASH eating plan, dietary sodium reduction, moderation of alcohol intake, physical activity
  • avoid tobacco products
  • management of risk factors
  • activate SNS and stress hormones
  • screen frequently for risk factors
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7
Q

beta blockers

A
  • decrease SNS stimulation
  • work centrally on vasomotor center and peripherally to inhibit NE release
  • block adrenergic receptors on blood vessels
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8
Q

ACE inhibitors

A
  • prevent conversion of angiotensin I to II
  • reduce vasoconstriction and sodium and water retention
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9
Q

A-II receptor blockers

A

prevent angiotensin II from binding to receptors in blood vessel walls

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10
Q

Calcium Channel blockers

A

increase sodium excretion and cause arteriolar vasodilation by preventing the movement of extracellular Ca into cells

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11
Q

Diuretics

A

reduce plasma volume

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12
Q

Common side effects of hypertension

A
  • orthostatic hypotension
  • sexual problems
  • dry mouth
  • frequent voiding
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13
Q

Resistant Hypertension

A
  • failure to reach goal BP with appropriate therapy and drug regimen; increased risk of MI or stroke
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14
Q

how to take accurate BP

A
  • no caffeine, nicotine, or exercise 30 minutes prior
  • rest quietly for 5 minutes prior
  • proper size and location of cuff
  • position arm at heart level
  • use auscultatory method
  • take BP in both arms and note difference
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15
Q

orthostatic HTN

A
  • BP and HR after supine for 5 minutes
  • Assist to standing
  • Measure BP and HR at 1 minute and 3 minutes of position change
  • Normal: SBP decreased (less than 10 mmHg, DBP and HR increased slightly
  • Abnormal:
  • SBP decreased 20 mmHg or more
  • DBP decreased 10 mmHg or more
  • HR increased 20 beats or more
  • Report of lightheaded or dizzy
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16
Q

Reasons for poor adherence

A
  • inadequate education
  • low health literacy
  • unpleasant side effects
  • stop taking medication
  • increased cost
  • lack of insurance
17
Q

measures to enhance compliance

A
  • individualize care plan
  • active patient participation
  • select affordable drugs
  • involve caregivers/family
  • combination drug
  • patient teaching
18
Q

evaluate the effectiveness of treatment

A
  • meet goal BP
  • understand treatment plan
  • reports minimal side effects of drug
19
Q

age-related physical changes contribute to HTN

A
  • Loss of elasticity of artery
  • Increased collagen and stiffness in myocardium
  • Increased peripheral vascular resistance
  • Decreased adrenergic receptors
  • Blunted baroreceptor reflex
  • Decreased renal function
  • Decreased renin responds to Na/H20 depletion
20
Q

Hypertensive crisis

A
  • SBP greater than 180 mmHg or DBP greater than 120 mmHg
21
Q

Hypertensive emergency

A
  • target organ damage
  • requires hospitalization
  • severe problems:
    1. encephalopathy
    2. stroke
    3. MI
    4. renal failure
    5. retinopathy
    6. aortic aneurysm
    7. intracranial/subarachnoid hemorrhage
21
Q

Hypertensive emergency

A
  • target organ damage
  • requires hospitalization
  • severe problems:
    1. encephalopathy
    2. stroke
    3. MI
    4. renal failure
    5. retinopathy
    6. aortic aneurysm
    7. intracranial/subarachnoid hemorrhage
22
Q

Hypertensive urgency

A
  • no evidence of target organ disease
  • hospitalization not required
  • associated with chronic stable disorders = CHF, CVA, angina
23
Q

Clinical manifestations of hypertensive episodes

A
  • hypertensive encephalopathy – nausea, seizures, confusion, trauma, retinal changes, vomiting
  • renal insufficiency
  • cardiac decomposition – chest pain, MI, pulmonary edema, dyspnea, unstable angina, heart failure
  • aortic dissection – chest and back pain, reduced/absent pulses

Adult Health I (4 decks)

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