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MIDTERMS COVERAGE > HYPERTENSION > Flashcards

HYPERTENSION Flashcards

1
Q

A systolic blood pressure (SBP) of 140 mm Hg or higher or a diastolic blood pressure (DBP) of 90 mm Hg or higher, based on the average of two or more accurate blood pressure measurements taken 1 to 4 weeks apart by health care provider.

A

Hypertension

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2
Q

Normal Blood Pressure

A

120/80

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3
Q

Systolic and Diastolic BP of Prehypertension

A

Systolic: 120-139

Diastolic: 80-89

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4
Q

Systolic and Diastolic of Stage 1 Hyperstension

A

Systolic: 140-159

Diastolic: 90-99

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5
Q

Systolic and Diastolic of Stage 2 Hypertension

A

Systolic: ≥160

Diastolic: ≥100

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6
Q

Primary Hypertension

A

-Essential HTN (Hypertension)
-High blood pressure from an unidentified cause
-95% of cases

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7
Q

Occurs when a cause for a high blood pressure can be identified

A

Secondary Hypertension

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8
Q

Major Risk Factors of Hypertension

A

-Advancing adult age
-African American
-Drinking too much alcohol (i.e.. more than two drinks per day for men and more than one drink per day for women)
-Family History
-Gender-Related
- Men have greater risks until
45 and 64 years of age
-Women have greater risks at
65 years of age and later
- Overweight obesity
-Poor diet habits, particularly if it includes too much salt.

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9
Q

Clinical Manifestations of Hypertension

A

-Generally Asymptomatic
-SBP ≥ 140mmHg or DBP ≥ 90
mmHg

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10
Q

Common Symptoms of Hypertension

A

-Nose Bleeds
-Headaches
-Chest Pain
-Blood in urine
-Shortness of breath
-Vomiting or nausea
-Palpitations
-Dizzines
-Blurry Vision

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11
Q

Complications of Hypertension

A

-Coronary Artery Disease
-Chronic Renal Failure
-Congestive Heart Failure
-Cardiac Arrest
-Cerebrovascular Accident

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12
Q

Medical Management of Hypertension

A

-Weight Reduction
- Dietary Management (Utilize Dash)
-Moderation of alcohol consumption
-Avoidance of tobacco products
-Stress management
-Drug therapy (treatment and control)

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13
Q

T/F A weight loss of 22 lbs (10 kg) may decrease SBP by approximately 5 to 20 mmHg.

A

True

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14
Q

Drugs that decrease the volume of circulating blood

A

Diuretics

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15
Q

Drugs that reduce systemic vascular resistance

A

-Adrenergic Blockers
-Angiotensin inhibitors
-Calcium-channel blockers
-Direct vasodilators

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16
Q

A diuretics that inhibits Na+ reabsorption at distal convoluted tubule

A

Thiazide Diuretics

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17
Q

Thiazide Diuretics Drugs

A

-Chlorothiazide (Diuril)
-Hydrochlorothiazide (Hydrodiuril)

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18
Q

Inhibits Na+ reabsorption at ascending limb of Loop of Henle

A

Loop Diuretics

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19
Q

Loop Diuretics Drugs

A

Furosemide (Lasix)

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20
Q

Side Effects of Thiazide Diuretics

A

-Orthostatic hypotension
-Mild Hypokalemia

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21
Q

Side Effects of Loop Diuretics

A

-Orthostatic hypotension
-mild hypokalemia

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22
Q

Inhibits Na+-retaining and K+- wasting effects of aldosterone at the tubules

A

Potassium-sparing Diuretics

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23
Q

Side Effects of Potassium-sparing Diuretics

A

-Orthostatic hypotension
-Hypotension
-Hyperkalemia

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24
Q

Adrenergic Receptors

A

-Alpha 1 (a1)
-Alpha 2 (a2)
-Beta 1 (B1)
-Beta 2 (B2)

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25
Q

Alpha 1 (a1)

A

-Vasoconstriction
-Increased peripheral resistance
-Increased blood pressure

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26
Q

Alpha 2 (a2)

A

Inhibits release of NE

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27
Q

Beta 1 (B1)

A

-Increased HR
-Increased myocardial contractility
-Increased renin secretion

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28
Q

Beta 2 (B2)

A

-Vasodilation
-Decreased peripheral resistance
-Bronchodilation

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29
Q

What are the Alpha-Adrenergic Blockers?

A

-Centrally Acting
-a1-antagonist

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30
Q

Centrally-acting drugs

A

-Clonidine (Catapress)
-Methyldopa (Aldomet)

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31
Q

Reduces sympathetic outflow from CNS

A

Centrally-acting

32
Q

Blocks a1 receptors resulting in peripheral vasodilation

A

a1-antagonist

33
Q

Common symptoms of Alpha-Adrenergic Blockers

A

-Dry mouth
-Drowsiness

33
Q

Common symptoms of Alpha-Adrenergic Blockers

A

-Dry mouth
-Drowsiness

34
Q

What are the Beta-Adrenergic Blockers

A

-Cardioselective
-Non-selective

35
Q

Block B1-adrenergic receptors: decreased CO and reduced sympathetic vasoconstrictor tone

A

Cardioselective

36
Q

Cardioselective drugs

A

Atenolol
Esmolol (IV only)
Metoprolol

37
Q

Non-selective drugs

A

Propanolol (Inderal)

38
Q

Block B1 and B2- adrenergic receptors

A

Non-selective

39
Q

Symptoms of Cardioselective

A

Bradycardia

40
Q

Symptoms of Non-Selective

A

Bradycardia and Bronchoconstriction

41
Q

What are the Angiostensin Inhibitors

A

-Ace Inhibitors (ends with “pril”)
-Angiosten II receptor Blockers (ends with “sartan”)

42
Q

Ace inhibitors drugs

A

-Captopril (Capoten)
-Enalapril (Vasotec)

43
Q

Inhibit ACE, reduce conversion of angiotensin I to angiotensin II

A

ACE Inhibitors

44
Q

ACE inhibitors S/E

A

dry cough

45
Q

Prevent action of Angiotensin-II and produce vasodilation and increased Na+ and water excretion

A

Angiotensin II receptor Blockers

46
Q

Full effect on BP may not be seen for 3-6 weeks

A

Angiotensin II receptor Blockers

47
Q

Angiotensin II receptor Blockers

A

-Losartan (Cozaar)
-Telmisartan (Micardis)

48
Q

Cause vascular smooth muscle relaxation resulting in decreased SVR and arterial BP

A

Dihydropyridine

49
Q

Drug of Choice of Dihydropyridine

A

-Amlodipine (Norvasc)
-Felodipine (Plendil)
-Nicardipine
-Nifedipine (Adalat)

50
Q

Inhibit movement of Ca2+ across cell membrane, resulting in vasodilation

A

Non-Dihydropyridine

51
Q

Drug of Choice of Non- Dihydropyridine

A

-Diltiazem
-Verapamil

52
Q

What are the Calcium-Channel Blockers

A

-Dihydropyridine
-Non-Dihydropyridine

53
Q

Direct Vasodilator drug

A

-Hydralazine (Apresoline)

54
Q

Reduces SVR and BP direct arterial vasodilation

A

Hydralazine (Apresoline)

55
Q

Nursing Management Goal for Hypertension

A

Goal: To lower and control blood pressure without adverse effects and undue costs

56
Q

Nursing Management for Hypertension

A

-Patient Education
-Adherence to therapeutic regimen
-Follow-up care

57
Q

Nursing Management: Patient Education

A

-Educate on disease process and how to control it.
-Teach patient how to self-monitor BP
-Encourage to consult a dietician for dietary management
-Instruct to limit alcohol intake and avid tobacco products

58
Q

Nursing Management: Adherence

A

-Encourage participation in self-care activities
-Support patient in making small changes with each visit that moves them toward their goals.
-Check on progress of plans made during the previous visit
-Support groups

59
Q

Is a clinical syndrome associated with abrupt, marked increased in BP that causes an acute or rapidly progressing end-organ damage

A

Hypertensive Crisis

60
Q

Characterized by SBP >180 mm Hg or DBP > 120mmHg

A

Hypertensive Crisis

61
Q

Normal BP follow-up recommended

A

Recheck in 2 years

62
Q

Prehypertension BP follow-up recommended

A

Recheck in 1 year

63
Q

Stage 1 Hypertension Follow-up Recommended

A

Confirm within 1 month

64
Q

Stage 2 Hypertension Follow-up Recommendation

A

-Evaluate or refer to the source of care within 1 month
-For those with higher pressures (>180/100 mm Hg), evaluate and treat immediately or within 1 week, depending on clinical situation and complications

65
Q

Types of Hypertensive Crisis

A

-Hypertensive Emergency
-Hypertensive Urgency
-

66
Q

Severe BP elevation + actual or developing organ damage

A

Hypertensive Emergency

67
Q

Severe BP elevation without evidence of impending or progressive end-organ damage

A

Hypertensive Urgency

68
Q

Risk Factors of Hypertensive Crisis

A

-Poorly controlled hypertension
-Undiagnosed hypertension
-Abrupt discontinuation of medications

69
Q

Hypertensive Emergency Medical Management Goal

A

Goal: Gradual reduction of pressure

70
Q

Drug of choice for Hypertensive Emergency Medical

A

Nicardipine (Cardene)

71
Q

Hypertensive Emergency

IVF of Choice:

A

PNSS

72
Q

Hypetensive Urgency Medical Management Goal:

A

Normalize BP within 24 to 48 hours

73
Q

Drug of choice (PO) for hypertensive urgency

A

-Labetalol (Trandate)
-Captopril (Capoten)
-Clonidine (Catapress)

74
Q

Hypertensive Crisis Nursing Management

A

-Supportive Care
-Use infusion pump when giving
antihypertensive via IV
-Monitor vital signs frequently, especially BP

MIDTERMS COVERAGE (7 decks)

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