Hypertension

Question 1

What causes hypertension

Answer 1

Increased cardiac output ( higher heart rate and increased stroke volume)
Increased peripheral resistance ( elevated blood viscosity and decreased vessel diameter)

Question 2

What are the causes of secondary hypertension

Answer 2

Renal vascular disease
Valve disorders
Sleep apnea
Pregnancy
Thyroid disorders
Drugs

Question 3

What drugs can cause secondary hypertension

Answer 3

Oral contraceptives
Antihistamines
Corticosteroids

Question 4

What does continued hypertension do to the blood vessel

Answer 4

Hypertrophy
Hyperplasia
Inflammatory response

Question 5

What are the risk factors for hypertension

Answer 5

Family history
Increasing age
Cigarette smoking
Obesity
Heavy alcohol consumption
Black race
Men (early to middle adult hood)
Women (over 50 yrs)
High sodium diet
Low intake of K+, Ca++, Mg++
Glucose intolerance

Question 6

Early stage hypertension has no distinct s/s other than an elevated what

Answer 6

Bp

Question 7

what is the most common side effect of HTN

Answer 7

no symptoms/asymptomatic

Question 8

What are s/s of hypertension

Answer 8

Asymptomatic
Headache
Visual disturbances
Chest pain
Flushed face
Epistaxis
Dizziness

Question 9

what is epistaxis

Answer 9

nose bleeds

Question 10

What is complicated hypertension

Answer 10

Sustained hypertension that has effects beyond hemodynamics

Question 11

what does continued HTN do to the blood vessel

Answer 11

hypertrophy
hyperplasia
inflammatory response

Question 12

what is hypertrophy

Answer 12

cells get larger

Question 13

what is hyperplasia

Answer 13

enlargement of an organ or a tissue that can create more & more cells

Question 14

what is inflammatory response for hypertension

Answer 14

decreases diameter of blood vessel

Question 15

What are the two major mechanisms of tissue damage for complicated hypertension

Answer 15

Ischemia
Edema

Question 16

what is ischemia

Answer 16

not enough o2 getting to where it needs to go and it damages tissue

Question 17

What are the treatment goals for hypertension

Answer 17

Focus on systolic bp
< 130/80

Question 18

What are some non medicine related treatments for a pt with hypertension

Answer 18

Lifestyle modifications
Diet
Exercise
Moderate alcohol consumption

Question 19

If pt has normal bp what is the recommended follow up procedure

Answer 19

Evaluate bp yearly
Encourage healthy lifestyle

Question 20

What is the recommended treatment/ follow up for a pt with elevated bp

Answer 20

Recommend healthy lifestyle
Reassess pt in 3-6 months

Question 21

What is the recommended treatment/follow up for a pt that has stage I hypertension

Answer 21

Lifestyle modifications
Reassess 3-6 months
Begin therapy it still not controlled

Question 22

What is the recommended treatment/ follow up for stage 2 hypertension

Answer 22

Lifestyle modifications and antihypertensive therapy
Reassess 3-6 months

Question 23

What are drugs a pt can take for hypertension (6)

Answer 23

ACE inhibitors
Beta Blockers
Calcium Antagonists
Alpha-Adrenergic Antagonists
Furosemide
Hydrochlorothiazide

Question 24

What are the three antihypertensive drugs

Answer 24

Ace inhibitors
Beta blockers
Calcium antagonists

Question 25

what are the side effects for alpha-blockers

Answer 25

orthostatic hypertension vertigo tachycardia sexual dysfunction

Question 26

what are the side effects of furosemide

Answer 26

decreased bp photosensitivity increase bs excrete K+

Question 27

what med is hydrochlorothiazide classed as

Answer 27

diuretic

Question 28

what is hydrochlorothiazide used to lower

Answer 28

blood pressure

Question 29

what is the upside of taking hydrochlorothiazide

Answer 29

normalizes bp on its own or w/ other hypotensive meds

Question 30

what is the downside of taking hydrochlorothiazide

Answer 30

hypokalemia hypocholremia hyperuricemia hyponatremia hyperglycemia dehydration promotes renal calcium retention

Question 31

what nursing care things will we do with pt with hypertension

Answer 31

daily wt I&O urine output response of b/p electrolytes take pulses ischemic episodes (TIA) complications

Question 32

what are the complications of hypertension (4 C's)

Answer 32

CAD CRF CHF CVA

Question 33

what is orthostatic hypotension

Answer 33

a decrease in both systolic & diastolic BP upon standing

Question 34

how much does the bp drop for the systolic when they have orthostatic hypotension

Answer 34

20 mmHg or a greater drop

Question 35

how much does the bp drop for the diastolic when they have orthostatic hypotension

Answer 35

10 mmHg or a greater drop

Question 36

what are the acute orthostatic hypotension s/s (7)

Answer 36

altered body chem drug action prolonged immobility starvation physical exhaustion volume depletion venous pooling

Question 37

what is idopathic hyoertension

Answer 37

no known cause of HTN

Question 38

what are the s/s for orthostatic hypotension

Answer 38

dizziness blurring or loss of vision syncope & fainting

Question 39

orthostatic hypotension is most common in the elderly when

Answer 39

postprandial (after meals)

Question 40

how do we check orthostatics

Answer 40

lying, sitting, and standing

Question 41

how often might we check orthostatics in a shift

Answer 41

TID/QID

Question 42

which decrease is more significant in the orthostatic bp

Answer 42

20 mmHg systolic

Question 43

what is the most important thing when a pt has orthostatic hypotension

Answer 43

fall precautions assist w/ standing/sitting

Question 44

how can we eliminate any known cause for orthostatics

Answer 44

adjust meds give volume replace electrolytes assist w/ frequent repositioning