Hypertension

Question 1

Pathophysiology

Answer 1

BP: strength of blood pushing against the sides of arteries

HTN: average BP that is higher than normal over a period of time

Question 2

BP is regulated by which nervous system?

Answer 2

ANS

Question 3

what are the BP classifications?

Answer 3

<130 and <85
130-139 and/or 85-89 (high/normal)
140-159 and/or 90-99 (grade 1)
>160 and/or >100 (grade 2)

Question 4

disease course and expected findings

Answer 4

high BP is asymptomatic, “silent killer”

orthostatic hypotension

S3 ventricular gallop; normal in elderly, pregnancy, adolescent, athletes

S4 atrial gallop; pathological

Question 5

risk factors

Answer 5

primary (essential): family history, AA, smoking, postmenopausal, excess sodium, obesity, physical inactivity, drugs, alcohol, diet

secondary: results from another disorder, kidney disease, pheochromocytoma, cushings, brain tumors, drugs

Question 6

diagnostics and labs

Answer 6

serial BP readings, cholesterol levels, microalbuminuria (small amounts of protein in urine)

Question 7

meds

Answer 7

garlic and coenzyme Q10: AE bleeding and liver damage

ACEi & ARBs: allergic reaction angioedema, assess for hyperkalemia, hold BP <100

BB: hold for HR <50-60, hold for BP <90-100

CCBs: no grapefruit juice

diuretics: daily weights, assess for dehydration and electrolyte imbalance

loop and thiazide: hypokalemia & hypomagnesemia, eat foods high in K

K sparing: SE hyperkalemia, avoid foods with K

Question 8

complications and nursing care

Answer 8

• assess BP in both arms with right sized cuff
• palpate pulses
• check temp in lower extremities
• can lead to stroke, heart failure, vision loss, heart attack, kidney disease, erectile dysfunction
• commitment to long term therapy
• DASh diet
• encourage drug adherence
• BP trackers
• salt reduction
• limit coffee, green/black tea
• reduce exposure to air pollution