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
Alpha 1 (a1)
-Vasoconstriction -Increased peripheral resistance -Increased blood pressure
26
Alpha 2 (a2)
Inhibits release of NE
27
Beta 1 (B1)
-Increased HR -Increased myocardial contractility -Increased renin secretion
28
Beta 2 (B2)
-Vasodilation -Decreased peripheral resistance -Bronchodilation
29
What are the Alpha-Adrenergic Blockers?
-Centrally Acting -a1-antagonist
30
Centrally-acting drugs
-Clonidine (Catapress) -Methyldopa (Aldomet)
31
Reduces sympathetic outflow from CNS
Centrally-acting
32
Blocks a1 receptors resulting in peripheral vasodilation
a1-antagonist
33
Common symptoms of Alpha-Adrenergic Blockers
-Dry mouth -Drowsiness
33
Common symptoms of Alpha-Adrenergic Blockers
-Dry mouth -Drowsiness
34
What are the Beta-Adrenergic Blockers
-Cardioselective -Non-selective
35
Block B1-adrenergic receptors: decreased CO and reduced sympathetic vasoconstrictor tone
Cardioselective
36
Cardioselective drugs
Atenolol Esmolol (IV only) Metoprolol
37
Non-selective drugs
Propanolol (Inderal)
38
Block B1 and B2- adrenergic receptors
Non-selective
39
Symptoms of Cardioselective
Bradycardia
40
Symptoms of Non-Selective
Bradycardia and Bronchoconstriction
41
What are the Angiostensin Inhibitors
-Ace Inhibitors (ends with "pril") -Angiosten II receptor Blockers (ends with "sartan")
42
Ace inhibitors drugs
-Captopril (Capoten) -Enalapril (Vasotec)
43
Inhibit ACE, reduce conversion of angiotensin I to angiotensin II
ACE Inhibitors
44
ACE inhibitors S/E
dry cough
45
Prevent action of Angiotensin-II and produce vasodilation and increased Na+ and water excretion
Angiotensin II receptor Blockers
46
Full effect on BP may not be seen for 3-6 weeks
Angiotensin II receptor Blockers
47
Angiotensin II receptor Blockers
-Losartan (Cozaar) -Telmisartan (Micardis)
48
Cause vascular smooth muscle relaxation resulting in decreased SVR and arterial BP
Dihydropyridine
49
Drug of Choice of Dihydropyridine
-Amlodipine (Norvasc) -Felodipine (Plendil) -Nicardipine -Nifedipine (Adalat)
50
Inhibit movement of Ca2+ across cell membrane, resulting in vasodilation
Non-Dihydropyridine
51
Drug of Choice of Non- Dihydropyridine
-Diltiazem -Verapamil
52
What are the Calcium-Channel Blockers
-Dihydropyridine -Non-Dihydropyridine
53
Direct Vasodilator drug
-Hydralazine (Apresoline)
54
Reduces SVR and BP direct arterial vasodilation
Hydralazine (Apresoline)
55
Nursing Management Goal for Hypertension
Goal: To lower and control blood pressure without adverse effects and undue costs
56
Nursing Management for Hypertension
-Patient Education -Adherence to therapeutic regimen -Follow-up care
57
Nursing Management: Patient Education
-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
Nursing Management: Adherence
-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
Is a clinical syndrome associated with abrupt, marked increased in BP that causes an acute or rapidly progressing end-organ damage
Hypertensive Crisis
60
Characterized by SBP >180 mm Hg or DBP > 120mmHg
Hypertensive Crisis
61
Normal BP follow-up recommended
Recheck in 2 years
62
Prehypertension BP follow-up recommended
Recheck in 1 year
63
Stage 1 Hypertension Follow-up Recommended
Confirm within 1 month
64
Stage 2 Hypertension Follow-up Recommendation
-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
Types of Hypertensive Crisis
-Hypertensive Emergency -Hypertensive Urgency -
66
Severe BP elevation + actual or developing organ damage
Hypertensive Emergency
67
Severe BP elevation without evidence of impending or progressive end-organ damage
Hypertensive Urgency
68
Risk Factors of Hypertensive Crisis
-Poorly controlled hypertension -Undiagnosed hypertension -Abrupt discontinuation of medications
69
Hypertensive Emergency Medical Management Goal
Goal: Gradual reduction of pressure
70
Drug of choice for Hypertensive Emergency Medical
Nicardipine (Cardene)
71
Hypertensive Emergency IVF of Choice:
PNSS
72
Hypetensive Urgency Medical Management Goal:
Normalize BP within 24 to 48 hours
73
Drug of choice (PO) for hypertensive urgency
-Labetalol (Trandate) -Captopril (Capoten) -Clonidine (Catapress)
74
Hypertensive Crisis Nursing Management
-Supportive Care -Use infusion pump when giving antihypertensive via IV -Monitor vital signs frequently, especially BP