Hypertension Flashcards
What is blood pressure?
The amount of pressure placed on the arterial muscle walls to propel blood through the body.
What are the two types of hypertension?
- Essential/Primary – no known cause but risk factors are considered
- Secondary – diseases and/or medications that cause hypertension
What is normal BP?
systolic < 120 and diastolic < 80
What is hypertensive crisis BP?
systolic > 180 and diastolic > 120
(consult your doctor immediately)
Where can hypertension headaches be located?
- Diffuse (holocephalic)
- Sides of the head
- Back of the head (occiput)
- Behind the eye(s)
What can patients feel when experiencing hypertension headaches?
- Pressure
- Pulsation
- Nausea
- Dizziness
- Blurred vision
What are some nonspecific symptoms a patient can have when initially diagnosed with HTN?
- headaches
- dizziness
- fainting
- nose bleeds
What are some manifestations on vasculature present in patients experiencing long-term complications of HTN?
- HTN will affect ALL arteries
- affects macrovasculature (heart) and microvasculature
- can impact microvasculature supply blood to the brain, eyes, kidneys
- brain = stroke
What diagnostic tests can be ordered to determine if a patient is experiencing long-term complications of HTN?
- There are no lab tests that can definitively diagnose hypertension.
- Some lab tests can be indicative of secondary hypertension.
- Hematuria, proteinuria, elevated BUN and creatinine indicate renal disease.
- Chest x-ray may indicate cardiomegaly (heart gets bigger b/c it has to work harder)
- Left atrial and left ventricular enlargement can be detected via x-ray and ECG.
How much sodium should patients with HTN have per day?
- Less than 2300 mg per day (avoid/limit salt intake)
- TEACH patients how to read food labels
What are some weight reduction interventions for patients with HTN?
- Weight loss encouraged if BMI is elevated
- Total fat: 20%-35% of daily caloric intake.
- Saturated fat: less than 10%
- Cholesterol: less that 300 mg/d
What are some alcohol intake interventions? What is considered a drink?
- Limit alcohol intake to no more than 1-2 drinks daily.
- 1.5 ounces of liquor (spirits)
- 5 ounces of wine
- 12 ounces of beer
What are some physical activity interventions?
- Emphasize starting slowly and gradually
- 30-45 minutes (3-5 x/week)
- Work up to more vigorous
- Report shortness of breath, fainting, or chest pain
What are some medications used to treat HTN?
- Diuretics
- Thiazides
- ACE-Inhibitors
- ARBs
- Calcium Channel Blockers
- Beta Blockers
What is Orthostatic Hypotension?
Orthostatic hypotension is a decrease in blood pressure (20 mm Hg systolic and/or 10 mm Hg diastolic) when the client changes position.
How do you take orthostatic blood pressure?
Take blood pressure with the client in the supine (lying) or sitting position, wait at least 2 minutes later and take reading with the client standing.
Why does hypertension lead to so many complications?
High blood pressure can constrict and narrow the blood vessels, which eventually damages and weakens them throughout the body, leading to decreased tissue perfusion.
What are some long-term complications of HTN on the cardiovascular system?
- Coronary disease
- Cerebral disease
- Peripheral vascular disease
- CAD
- Angina
- Myocardial Infarct/Heart Attack
What are some long-term complications of HTN on the nervous and urinary system?
- Cerebrovascular Accidents/Stroke
- Transient Ischemic Attacks/”Little strokes”
- Retinal Changes – Vision Problems
- Kidney Changes – Chronic Kidney Disease
What vision changes can HTN cause?
- Cotton Wool Spots – indicate ischemia
- A block in the artery that brings blood to the retina may cause the ischemia.
- Cotton wool spots are made up of swollen debris from local cells.
- spots are not harmful, but indicate underlying issue to blood vessels in the eye
- Flame Hemorrhages – indicate blood that has leaked out of the blood vessels
Compare hypertensive urgency and hypertensive crisis.
- hypertensive urgency: BP is a potential risk, but has not yet caused acute end-organ damage (BP controlled over days/weeks)
- hypertensive crisis: severe HTN with acute impairment of an organ system (BP lowered aggressively over mins/hours)