Hypertension

Question 1

How to calculate MAP

Answer 1

SBP + (2xDBP)

then divide by 3

Question 2

MAP is the mean (average) arterial pressure during a cardiac cycle. It is an indicator of

Answer 2

organ perfusion

> 60 mmHg is enough to sustain the organs of an avg. person
< 60 organs are not perfused and will eventually become ischemic

Question 3

Strength of blood pushing against the sides of arteries. Influenced by cardiac output (CO) & systemic peripheral vascular resistance (PVR)

Answer 3

Blood pressure (BP)

Question 4

Average BP that is higher than normal over a period of time consisting of two or more office visits

Answer 4

Hypertension

Question 5

Indicates the health and tone of arterial walls

Answer 5

pulse pressure

Question 6

High Blood Pressure is usually __________. Present for years without discovery, meanwhile doing damage to organs. AKA the “silent killer”

Answer 6

asymptomatic

Question 7

Decrease in BP by 20 mmHg systolic and/or 10 mmHg diastolic

Answer 7

orthostatic hypotension

Question 8

S3 heart sound

Answer 8

“Kentucky”, Ventricular Gallop, Normal in elderly, pregnant, and adolescent/athletes

ABNORMAL–> Systolic HF

Question 9

S4 heart sound

Answer 9

“Tennessee”, Atrial Gallop, Almost ALWAYS pathological, Stiff Ventricle, diastolic dysfunction

ABNORMAL–> Left ventricular hypertrophy

Question 10

Primary HTN

Answer 10

Chronic elevation in BP that occurs without disease. Can be diastolic, systolic, or both. Results in damage to vital organs & causes thickening of arterioles.

Question 11

Secondary HTN

Answer 11

caused by underlying health problem

Question 12

Nonmodifiable risk factors

Answer 12

• Age: develops 30-50yo
• Gender: Men <55, Women >55
• Ethnicity: African American
• Family Hx: Parent or Siblings w/HTN

Question 13

Modifiable risk factors

Answer 13

• Obesity
• Stress
• Substance abuse
• Excess Na & water retention
• Elevated Lipids: Triglycerides and Cholesterol
• Sedentary Lifestyle
• Diabetes: blood vessel disease in HTN
• Diet: increased sat fats & salt –> plaque buildup

Question 14

Diagnostics of HTN

Answer 14

-serial BP readings
-cholesterol levels
-microalbuminuria

Question 15

Monitor for hypotension when using all HTN drugs

True or False

Answer 15

True

Question 16

If patient has a persistent, dry cough when on ACEi, switch to

Answer 16

ARBs

Question 17

Adverse effect of Garlic & Coenzyme Q10

Answer 17

bleeding and liver damage

Question 18

Hold beta blockers when

Answer 18

HR <50-60 and SBP <90-100

Question 19

What fruit should be avoided when taking calcium channel blockers?

Answer 19

grapefuit

Question 20

Assess dehydration & electrolyte imbalance when patient is taking

Answer 20

diuretics

Question 21

Side effects of Loop & Thiazide medications

Answer 21

HYPOkalemia (life-threatening dysrhythmias)
HYPOmagnesemia

Question 22

K sparing medications can cause __________ and the patient should avoid foods high in potassium.

Answer 22

HYPERkalemia–> Life Threatening dysrhythmias

Question 23

What meds?

o Allergic Rxn: Angioedema
o Assess for Hyperkalemia
o Hold for SBP <100

Answer 23

ACEi & ARBs

Question 24

No ACEi and ARBs in women who are

Answer 24

pregnant or planning pregnancy

Question 25

Palpating each carotid separately prevents

Answer 25

blocking perfusion to the brain

Question 26

Temp. differences in lower extremities and cap. refill is an indicator of

Answer 26

poor perfusion

Question 27

Target BP for pts w/ and w/o diabetes

Answer 27

w/ diabetes - BP <130/90 mm/Hg
w/o diabetes - BP <120/80 mm/Hg

Question 28

Consequences of high BP

Answer 28

stroke, vision loss, heart attack, heart failure, erectile dysfunction, kidney disease/failure

Question 29

What is the most important goal for someone with HTN?

Answer 29

Commitment to long term therapy

Question 30

Lab goals

Answer 30

Cholesterol <200 mg/dL
LDL <70 mg/dL
HDL >40 mg/dL
Triglycerides <150 mg/dL
HgA1C 6%
BS <130 mg/dL

Question 31

There is strong evidence for a relationship between high salt intake and increased blood pressure. Reduce salt added when preparing foods, and at the table. Avoid or limit consumption of high salt foods such as soy sauce, fast foods and processed food including breads and cereals high in salt. What is the restriction/limit of salt consumption?

Answer 31

Na restriction is usually no more than 2400 mg/day, preferred limit of
1500mg/day.

Avoid salt substitutes

Question 32

What is the recommended daily limit for alcohol consumption?

Answer 32

The recommended daily limit for alcohol consumptions is 2 standard drinks for men and 1.5 for women.

Avoid binge drinking.

Question 33

Strategies to lower BP

Answer 33

salt reduction, healthy diet & drinks, moderation of alcohol consumption, weight reduction, smoking cessation, regular physical activity, and reduce stress