Hypertension

Question 1

Hypertension
- risk factors
- complications
- nursing management
- patient education

be familiar with major side effects of beta blockers,
ace inhibitors
diuretics
calcium channel blockers

Question 2

What is hypertension ?

Answer 2

High blood pressure

Question 3

Is hypertension modifiable?

Answer 3

hypertension is one of the most important modifiable risk factors for the development of cardiovascular disease

Question 4

There are various stages of diagnosing hypertension such as a normal blood pressure being 120/80. An elevated blood pressure being 120-129/80.

What is considered to be hypertension stage 1 ?

what is considered to be hypertension stage 2?

Answer 4

130-139/80-89

140/90 and above

Question 5

what is the etiology of hypertension?

primary vs secondary?

Answer 5

primary hyerptwension is when you have hypertension without an identified cause
- this usually accounts for 90% of all cases of hypertension

secondary hypertension
- elevated blood pressured caused by an identified cause

Question 6

what are the goals of treatment for patients who have hypertension?

Answer 6

reduction of the blood pressure and preventing or lessening the extent of organ damage

Question 7

what is the non pharmacological approach to hypertension?

however what’s important to note about this change and what is followed by it if it doesn’t work ?

Answer 7

life style changes

typically we give patients 1-3 months to make life style changes, like exercise, weight loss, and diet, however if those changes don’t help lower the blood pressure, pharmacological treatment may be required

Question 8

what are some risk factors for hypertension?

Answer 8

aging
family history
obesity
smoking
hyperlipidemia
increased intake of salt or caffeine

Question 9

what is the treatment typically for patients who are diagnosed with secondary hypertension?

Answer 9

treat the cause
- for example if the patient who is pregnant, best way to get rid of gestational hypertension would be to deliver the baby when time is due

Question 10

what are some precipitation disorders or conditions that you can name that can cause secondary hypertension?

Answer 10

endocrine system disorders
medications
pregnancy

Question 11

hypertension is known as the ___? because it tends to be ___ for patients

Answer 11

silent killer

asymptomatic

Question 12

what are some clinical manifestation we could potentially see in a patient who has hypertension?

Answer 12

headache
visual distubrances
dizziness
chest pain
tinnitus
flushed face
epistaxis

Question 13

what is the most common complication of hypertension?

Answer 13

target organ diseases
- hypertensive heart disease
- peripheral vascular diseae
- neprhosclerosis
- retinal damage

Question 14

what is the diagnostic study for hypertension?

Answer 14

assessing and monitoring blood pressure with a machine or manual

Question 15

why is it important to assess the renal function regarding hypertension ?

Answer 15

renal function would decreases meaning urine output would decrease = decreased perfusion

ironically when the blood feels like it isn’t getting well perfused, the kidneys who help maintain blood pressure think oh its because the blood pressure is low, so it will increase it and lower urine out put

Question 16

how much sodium would a patient diagnosed with hypertension be recommended to consume daily?

Answer 16

2 grams

Question 17

what are some medications that we commonly give patients with have hypertension?
(4 we will focus on )

Answer 17

beta blockers
ace inhibitors
diuretics
calcium channel blockers

Question 18

what does beta blockers do ?

Answer 18

lowers heart rate in order to decrease blood pressure

Question 19

what are major side effects of beta blockers? (5)
- remember these !!

Answer 19

bradycardia
bronchospasm
hyperglycemia
agranulocytosis
hypotension

Question 20

what do ace inhibitors do ?

Answer 20

ace prevent peripheral vasoconstriction by blocking conversion of angiotensin 1 to angiotensin 2

Question 21

what are major side effects of ace inhibitors? (5)
- remember these

Answer 21

persitent dry cough
hypoglycemia - diabetes
brushing,petechiae,bleeding
hyperkalemia
diminished taste

Question 22

what do diuretics do ?

Answer 22

help eliminate fluid from the body
by inhibitor of sodium reabsorption

Question 23

what are major side effects of diuretics? (4)

remember the only one that isn’t potassium wasting would be spirolocatone

Answer 23

• hypokalemia
• orthostatic hypotension
• ototoxicity
• hypovolemia

Question 24

what does calcium channel blockers do ?

Answer 24

they decrease cardiac contractility and the workload of the heart ; promoting vasodilation of the coronary and peripheral vessels

Question 25

what are major calcium channel blocker side effects? (5)

Answer 25

reflex tachycardia caused by hypotension peripheral edema consitpation flushing of the skin dont drink grapefruit juice cause it will increase the toxicity

Question 26

what does beta blockers end in what does ace end in what does calcium end in ?

Answer 26

lol pril pine

Question 27

what are some things we want to educate our patient on when treating or managing hypertension?

Answer 27

promotion of exercise weight loss avoid smoking/alcohol relaxation for stress medication compliance

Question 28

what is hypertensive crisis ?

Answer 28

an acute and life treating condition requiring immediate reduction in blood pressure

Question 29

what is the diagnostic for hypertensive crisis ?

Answer 29

a blood pressure reading of 180 systolic and 120 diastolic

Question 30

what are the clinical manifestation of a patient with hypertensive crisis ?

Answer 30

severe headache blurred vision changes in neuro status dyspnea cyanosis seizures tachycardia and tachypnea

Question 31

what are the interventions to help a patient with hypertensive crisis? (5)

Answer 31

patent airways administer iv antihypertensive assess bp every 5 mins HOB elevated insert foley

Question 32

if a patient who is in hypertensive crisis and we are administer antihypertensive medications through iv, its a no brainer that hypotension is likely to occur, what would be the protocol or next step to help the patient if hypotension were to occur?

Answer 32

place the patient supine