Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS 347 EXAM 3 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What does hypertension mean?

A

High blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

As blood pressure increases so does the risk of? (5)

A

Myocardial infarction
Heart failure
Stroke
Renal disease
retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypertension effects about what percentage of United state adults?

A

46%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is hypertension management??
What are the 2 target goals

A

Target goals are based on
Age & comorbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who has the highest risk of hypertension?
Race & gender

A

Black people
Female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Black people have less of response to what?
And why does this effect them on getting angioedema?

A

Renin inhibiting medication

Because we want to stop our reninfrom our kidneys from sodium/fluid retention but since they have less response to the actual medication to renin it’s hard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Black people are at increased risk of what?
And how does that work?

A

Angioedema with ACE inhibitors
( Angiotensin converting enzyme)

The whole point of the the renin system is to sodium/fluid retention but since the ACE inhibitor is going to double that retention, we are going to cause edema ( swelling )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which race group is less likely to receive treatment?

A

Hispanics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypertension is more common on men before the age of what?

A

Before middle age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Women have a higher risk of getting hypertension how (3)?

A

Oral contraceptives
Preeclampsia
After menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does blood pressure mean ?

A

Force exerted by blood against walls of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the blood pressure function ?

A

Cardiac output and systemic vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the formula for BP?

A

CO = SV x HR
cardiac output = stroke volume X heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the sympathetic nervous system effect our blood pressure?
It increased what 6 things?
CHII!!!

A

Cardiac contractility within seconds
Heart Rate
Increase Cardiac output
Increase systemic vascular resistance
Renin release
Vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does Parasympathetic effect blood pressure? (3)
It does what to your blood pressure?

A

It decreases your heart rate ( vagus nerve )
Decrease Cardic output

Decrease BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sympathetic causes what?
What happens to pupils?
What happens to saliva?
What happens to heart beat?
What happens to airways?
What happens to digestion?
What happened to liver?
What happens to intensities?
Also secrete what??
What happens to bladder?

A

Dilate pupils
Inhibit salivation
Increase heartbeat
Relax airways
Inhibit stomach activity
Inhibit gallbladder
Inhibit Activity intensities
Secrete epinephrine/adrenaline
Relaxes bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Parasympathetic
What happens to pupils?
What happens to saliva?
What happens to heart beat?
What happens to airways?
What happens to digestion?
What happened to liver?
What happens to intensities?
What happens to bladder?

A

Constrict pupils
Stimulate salvia
Slow heartbeat
Constrict airways
Stimulate stomach
Stimulate gallbladder
Stimulate intestines
Contract bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 5 sns receptors that effect blood pressure?

A

A1
a2
B1
B2
Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does A1 receptor effect blood pressure?

A

Vasoconstriction
Increased contractility
( positive inotropic ; contraction )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does A2 sns receptors affect blood pressure?
And explain the process of this?

A

Inhibit release of norepinephrine

When there isn’t a release of nonreponephrine, the blood pressure will drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does B1 sns affect blood pressure?

A

Increase contractility
Heart rate ( Chronotropic )
Conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the B2 sns affect receptor mean for Blood pressure?

A

Vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does dopamine do for sns receptor affecting blood pressure?

A

Vasodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where are baroreceptors located?

A

Carotids and aortic arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Baroreceptors are sensitive to what and what happens to our blood pressure?
Sensitive to stretching which happened with increased blood pressure
26
What are the function of Baroreceptors ?
Monitor how much blood you have your blood vessels and fixing it to have a normal BP
27
When the Baroreceptors notice a low blood pressure what does it do?
Activates the SNS And increase heart rate etc
28
When Baroreceptors detect a high blood pressure it’s going to do what?
Sending inhibitor impulse’s sympathetic nervous system ( Pretty much to stop SNS impulses from happening )
29
When the Baroreceptors send inhibitory impulses sns ? What does it cause? (3)
Decreased heart rate Decreased force of cardiac contraction Increased vasodilation of arterioles ( pretty much stopping sns impulses to happen and focus on psn )
30
When you have chronic hypertension what does that cause to Baroreceptors?
To reset baseline ( pretty much hypertensive state is there new normal, so like 130/90 is there new normal BP and the Baroreceptors don’t detect a need to change )
31
What are 3 factors that influence blood pressure?
Vascular endothelium Renal system Heart cells : natriuretic peptides : ANP/BNP
32
How does vascular endothelium affect blood pressure? What will it produce in order to maintain?
It produces vasoactive substances to maintain low arterial tone
33
Explain how vascular endothelium effects blood pressure
Along side the blood vessel, there are endothelium cells These endothelium cells are regulated by our vascular tone However when we have hypertension these endothelium cells are distrusted and causes vasocative substances to be released and causes our body to constrict Since the whole job of a vascular tone is to help with constriction of blood vessel to allow blood to come, but if we have high blood pressure we are going to constrict even more and not let that blood flow come in Causing that low arterial tone Meaning not all the blood is being pushed through, just bit by bit cause of that constriction
34
Not only does vascular endothelium cells effect our blood pressure but if we (2) it also effects the elasticity of vessels Think of which diseases
Smoke Diabetic mellitus
35
How does our renal system effect our blood pressure? (3)
Controls sodium excretion & extracellular fluid volume Renin system Prostaglandins - vasodilators
36
How does the control sodium excretion and ECF from the renal system effect our blood pressure?
If our reneal system is good enough We will be able to excret a good amount of sodium and extracellular fluid However with hypertension, it won’t be so it’ll retain it and cause high blood pressure
37
How does RAAS from renal system effect blood pressure ?
It’s our body’s response to the change and in low BP and will try to retain sodium and fluids in order to try to increase it but without good sodium excretion, the body will overaccumilate in collection of sodium
38
How does prostaglandins from ther renal system effect our blood pressure?
Our body produces prostaglandins in order to try to lower it by working as a Vasodilator
39
How does natriuretic peptides work to effect blood pressure?
They oppose ( anti diuretic hormone ) ADH and Aldosterone Which pretty much these two help retain fluids and sodium but since they are being opposed It helps us lower blood pressure & lower blood volume
40
What are the steps of how epinephrine and nonepinephrine factor into influence our blood pressure? (7)
Epinephrine and nonepnephrine are relaxed by the adrenal medulla They both increase cardiac output and contractility This activates B2 receptors in the skeletal muscle and causes Vasodilation Then it activates A1 adrenergic receptors in the skin & kidneys and causes vasoconstriction Which also angiotensin 2 stimulates aldosterone to be released from the adrenal cortex in order to promote Fluid retention Also ADH comes from posterior partition to increase fluid volume retention All of this causing our blood pressure to increase
41
What’s normal blood pressure Elevated blood pressure HTN stage 1 HTN stage 2
120/80 120-129/80 130-139/80-89 140+/90+
42
Primary/essential Hypertension Elevated BP is due to what? And what percentages of all cases?
Unknown cause 90-95% of all cases of hypertension
43
What are the many contributing causes of primary/essential hyper tension? (9) EEEOOO anagram
Altered endothelial function Diabetes Excess alcohol Increased SNS activity Increase sodium intake Overproduction of Sodium Overweight retaining hormones Tobacco
44
Secondary HTN Elevated blood pressure is what cause? And it accounts to what percentage of cases ?
Specific ; sudden development cause 5-10%
45
What are some findings that related to secondary HTN ? (8)
Aortic problems Cirrhosis Drug related Endocrine Neurological Pregnancy induced Renal problems Sleep apnea
46
What is the treatment of secondary HTN?
Removing or treating the underlying cause
47
What’s the big difference between primary and secondary HTN?
Primary is like genetics and preventable Secondary is sudden development due to underlying cause like pregnancy
48
Pathophysiology Primary hypertension How do we get increase blood pressure?
Increase CO or increase SVR
49
As hypertension progresses what rises and what goes back to normal?
SVR increases CO goes back to normal
50
What does SVR increase mean? And why does CO go back to normal
So if you have progressive hypertension The more your body is needing to pump blood through constrict blood vessel causes that’s increase in SVR That’s pretty much what it means SVR increases/the force the blood is needing to get through the blood vessels but since it’s hypertension, those vessels are small and tight and needs more At first we notice signs of trouble was but after some time it becomes our normal which is why CO gets back to normal because our Baroreceptors have gotten so use to it and reset the baseline
51
What are some risk factors of hypertension?? (13)
Age > 50 Alcohol Diabetes Ethnicity - black Excess Sodium intake Family history Gender Increased serum lipids - cholesterol Obesity Sedentary lifestyle Socioeconomic Stress Tobacco
52
What’s the 5 primary hypertension pathophysiology? Think of what is gonna cause this primary HTN WASIE!!
Altered renin angiotensin aldosterone mechanism Endothelial dysfunction insulin resistance & hyperinsulinemia Stress & increased SNS Water and sodium retention
53
How many people does high sodium diet develop into hypertension?
1 in 3 people
54
In the textbook, it mentions how it is very difficult to understand in who does sodium effect blood pressure in, weather some people needs lots of sodium vs some need very little to see an increase in blood pressure, however We understand it’s what type of component? Provide an example And having an increase risk of what?
Genetic component Such as black people having more risk of hypertension through salt Risk of renal dysfunction, endothelial dysfunction & heart failure
55
How does altered renin angiotensin aldosterone system effect primary hypertension pathophysiology?
Our body noticed a low blood pressure which Increases renin activates RAAS However when we have high blood pressure we want to inhibit the release of renin but we can’t because that became our new normal. So renin is just constantly raising our blood pressure due to that sodium/fluid retention
56
How does stress and increase sns activity effect primary hypertension pathophysiology? (3) Si in Spanish!! !! Say it outside
Causes vasoconstriction Increase heart rate Increase renin release
57
People exposed to high amounts of stress repeatedly are more likely to develop?
Hypertension
58
How does insulin resistance and hyperinsulinemia effect primary hypertension pathophysiology? (4) It stimulates what Impairs what?? Causes what?? Increased what??
It stimulates sns and impairs vasodilation ( nitric oxide ) Causes vascular hypertrophy Increase renal sodium reabsorption
59
Hypertension is also know to be as the what? Because why?
Silent killer Asymptomatic
60
What are some secondary clinical manifestations of hypertension? (5)
Fatigue Dizziness Palpitations Angina Dyspnea
61
Treatment goals Age > 65, SBP > 130 ambulatory in community setting ??? Goal? Age> 65, SBP > 130 care facility Age>18 with HTN, CVD All others without CVD
SBP<130 patient/team decision 130/80 <130/80
62
What are the two purposes of medication?
Decrease circulating blood volume Reduce systemic vascular resistance
63
Why do we want to reduce systemic vascular resistance?
Because we don’t want our body to have to use so much force to try to squeeze through the blood vessels, that’s what’s causing our hypertension
64
What are the 6 medications to help aid with hypertension?
Adrenergic inhibiting agents Ace inhibitors Angio 2 receptor blockers Calcium channel blockers Direct vasodilators Diuretics
65
How does adrenergic inhibiting agents work?
Decreasing sns stimulation Working centrally on Vasomotor center and peripherally to inhibit noephinephrine release or block adrenergic receptors on blood vessels
66
How does ACE inhibitors work? This also is known to cause cough and hypotension!
Prevent conversion of angiotensin 1 to angiotensin 2 Reduce vasoconstriction and sodium and water retention
67
How does A-2 receptors blockers work?
Prevent angiotensin 2 from binding to receptors in blood vessel walls
68
How does calcium channel blockers work? (CCB)
Increase sodium excretion and cause arteriolar vasodilation by preventing the movement of extracellular CA into cells
69
How does direct vasodilators work?
Relax vascular smooth muscle and reduce SVR
70
How does diuretics work?
Reduce plasma volume by increased sodium and water excretion and reduce vascular response to catecholamines
71
Hypertension drug therapy Patient with hypertension Patient with stage 2 hypertension What do we give
Nonpharmacologic treatment 1 first line pharamacologic drug Nonpharmacologic therapy 2 antihypertensives
72
When giving out drug therapy for hypertension we want the patient to make monthly follows up until they met there goal, and after they meet there go how often do they come back in for a check up?
3-6 months
73
We always want to provide patient education; when giving medication to patients how are we going to educate them ? (3)
Tell them to report all side effects If medication isn’t working, we can give them different ones to try for severe or undesirable Why they need to continue commitment/adherence to therapy
74
What are 4 common side effects of medication that we can provide patient education on? Explain each one too
Orthostatic hypotension - dizzy or faint when Change position Sexual problems - reduced libido or wre tile dysfunction Dry mouth Sugarless gum or candy Frequent voiding - take diuretic daily in the day to avoid getting up at night
75
What does resistant hypertension mean?
Failure to reach goal blood pressure with appropriate theory and drug regimen
76
When you have resistant hypertension what does that increase to you have? (2)
Stroke and myocardial infarction
77
What are the 6 causes of resistant hypertension? Examples of each as well
Improper BP measurement - wrong cuff size Volume overload - excess salt intake Drug induced or other causes - cocaine Associated conditions - alcohol, obesity Secondary hypertension - underlying cause like renal disease/failure Overactive renal nerve - renal nerve ablation
78
What’s the treatment for resistant hypertension?
You want to determine the fact that may be causing it
79
When providing nursing care we want to follow an anagram, what is it and what does it stand for? (8)
Diuretic Daily weight Input and output Urine output Response of blood pressure Electrolytes Take pulses Ischemic episodes (TIA) Complications 4 CAD, CRF, CHF, CVA
80
What’s the nursing diagnosis for hypertension? What we will see on our patient that will help us diagnosis hypertension (4) Think of AEEP!! OUTLOUD
Altered blood pressure ( measurement ) Ineffective tissue perfusion Impaired sexual function Potential complications : stroke & myocardial infarction
81
What are the goals/plans for nursing care for hypertension? (3) Don’t over think this, what are we literally wanting to do and help our patient with
Achieve and maintain goal blood pressure Minimal side effects Manage and cope with condition
82
How do you measure blood pressure? What are the steps you need to do^ You don’t want to do what things prior to the blood pressure exam; at least 30mins Always wanna make sure we deflate at what rate? If you can’t use upper arm we can use what machine? Always wanna get a good what?
Cuff on the arm brachial Smoking, exercise or caffeine We deflate at 2-3mm We can use Doppler Good cuff size
83
How do we measure blood pressure in orthostatic hypotension? We want to do what first? Then ? Normal(2) vs abnormal (4)
Blood pressure & hr after supine for 5 mins Assist to stand Measure BP and hr at 1-3mins of position change Normal decrease than SBP 10mm Increase DBP & HR Abnormal Decrease SBP 20mm Decrease DBP 10mm HR increase 20+ Report lightheaded or dizzy
84
Hypertension nursing implementation We want to do primary prevention, what is it ?? 2 main ones (2) (4) What are the first things we are trying to tell our patient !!
Lifestyles modifications - decreasing sodium & following DASH - education dangers of HTN Individual patient evaluation & education - screening programs - identify risk factors for HTN&CAD - BP measurement - drugs/previous treatment
85
How are we going to provide acute care for hypertension for our nursing implementation?(3) Think of like simple things, and what are we going to recommend ??
Monitor their blood pressure & VS If they have increase blood pressure follow up with health care provider Refer to appropriate personnel - dietician - physical therapist
86
How/why are we going to use screen programs for nursing implementation for hypertension?
Community based screening that use to help identify groups or people with high blood pressure
87
How are we going to perform ambulatory ( longer term care ) for hypertension for our nursing implementation? (9) LONG TERM THINK HEADP!!
Help patient reduce blood pressure Evaluate therapeutic effectiveness Detect and report adverse effects Assess and enhance adherence Patient and caregiver teaching Nutritional therapy Drug therapy Lifestyle modifications Home blood pressure monitoring
88
How are going to implement home blood pressure monitoring for hypertension?? (4) ( don’t over think, when they go home, we expect them to know and do these things ?!)
Using proper equipment & procedure Changing lifestyle Medication education Adherence to therapy
89
Why do we want to emphasize the important to patient adherence for hypertension when it comes to our nursing implementation?
Because it’s a major problem !!! Causes more serious complications
90
What are some reason for poor adherence? (6)
Inadequate teaching Low health literacy Unpleasant side effects of drugs Return to normal blood pressure High cost of drugs Lack of insurance
91
Lastly we want to promote measures that will enhance compliance when teaching about hypertension, what are they that we are going to implement as a nurse? (6)
Individualize plan Active patient participation Select affordable drugs Involve caregivers Combination drugs Patient teaching
92
Gerontologic considerations Percentage risk and greater at what age?
90% risk 55 age
93
What’s the 7 pathophysiology for gerontologic considerations BDDDLII!!
Blunted Baroreceptors reflexes Decreased renal function Decreased renin response to sodium and water depletion decreased adrenergic receptor sensitivity Loss of elasticity in arteries Increased collagen and stiffness in myocardium Increase PVR
94
Gerontologic considerations Hypertension Older patients are more likely to have what type of hypertension and means what?
White coat Higher BP in hospitals than at home
95
Gerontologic considerations Hypertension Elder will normally have altered what (3)?
Drug absorption Metabolism Excretion
96
Gerontologic considerations Eldery will have a wider what ? So we have to assess for? (3)
Auscultatory gap Orthostatic hypotension Acute kidney injury Postprandial hypotension
97
We always want to be cautions of using what medication to treat hypertension for elders?
nsaids
98
Most elderly patients starts with what type of medication? (1) And then move onto? (2) You also always want to smart small dose before going to big dose!!
Diuretics Calcium channel blocker Ace inhibitor
99
What is hypertensive crisis? Measurement ?
Emergency Anything above 180/120
100
Does hypertensive crisis emergency require hospitalization?
Yes!!! It’s an emergency
101
What does hypertensive Crisis for emergency target and from that it can cause? (8)
Target organ damage Encephalopathy Intracranial/subarachnoid hemorrhage Heart failure Myocardial infarction Renal failure Aneurysm Retnioplathy
102
When hypertensive emergency is untested what happens?
79% death rate
103
Hypertensive urgency, does it need hospitalization?
No
104
Hypertensive urgency, does it have organ disease?
No
105
Hypertensive urgency is mainly associated with what? And examples
Chronic stable discords - stable angina - chronic heart failure - prior myocardial infarction - CVA
106
Hypertensive crisis What can cause it? (3) And leads to ? (3)
Cocaine Amphetamines LSD Stroke myocardial infarction Encephalopathy
107
What are clinical manifestations of hypertensive encephalopathy? (6) Think of the brain 🧠
Headache Nausea/vomitting Seizures Confusion Coma Retinal changes
108
What are some clinical manifestations if hypertensive crisis for cardiac decompensafion? (4)
Myocardial infarction Pulmonary edema Chest pain Dyspnea
109
What are clinical manifestations of hypertensive crisis for aortic dissection? (2)
Chest/back pain Reduce/absent peripheral pulses
110
What is the hypertensive crisis emergency nursing care ? (2) Emergency is causing a target to what??
Treat related BP to evidence target organ IV drugs : slow titration
111
What type of drugs are we going to be giving to a hypertensive crisis emergency patient? (3)
Adrenergic inhibitors Calcium Channel blockers Vasodilators ( sodium nitroprusside )
112
We always want to asses a patients vitals, but what’s so important to understand that when giving drugs to a patient with hypertensive crisis Emerengency is?
They are rapid onset
113
What are some special considerations to take into play with hypertensive crisis emergency? (3)
Aortic dissection Acute ischemic stroke Post stroke patients
114
What are nursing implementations we are going to do for hypertensive crisis? (5)
Monitor cardiac/renal function Neurological checks Bed rest Determine cause Education to prevent further
115
Hypertensive urgency - outpatient What types of medications will we give? (4) And they require a follow up often in 24 hours? True of false?
Captopril Labefaol Clonidine Amlodipine True
116
As treatment for hypertensive crisis a patient has recieved sodium nitroprusside for 3 days. For which reason would the nurse plan to monitor the patient thiocyanate levels?
The medication is metabolized to cyanide and then thiocyanate It can reach lethal levels
117
How much sodium do you restrict on a hypertensive patient?
1500mg

NURS 347 EXAM 3 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions