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Nursing Test 3 > Hypertension > Flashcards

Hypertension Flashcards

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0
Q

What is the most sensitive organ to any change in perfusion

A

Brain

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1
Q

What are 3 elements that need to stay the same in the brain

A

Oxygen
Blood pressure
Glucose

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2
Q

3 essential organs

A

Heart
Kidneys
Blood/brain

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3
Q

What are some signs something is wrong with perfusion

A

Pale, cyanotic, confusion, sweating, sob, dizzy, blurred vision

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4
Q

What is a blood glucose reading when a person starts to feel bad

A

60-70

The brain is responding to low blood glucose

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5
Q

1st sign or symptom of any change in cardiac output is r/t

A

Brain or LOC

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6
Q

Areas to put stethoscope

A

APTM

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7
Q

What is PMI? Where can you hear it?

A

Point of maximal impulse
It is a place to put your stethoscope
5th ICS MCL Left Side

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8
Q

What % or oxygen does room air give you

A

21%

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9
Q

When do the coronary arteries fill

A

During diastole

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10
Q

What percent of oxygen is 2L nasal cannula

A

24%

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11
Q

What is the normal shape of the heart

A

Football shaped

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12
Q

Why do we care about shape of the heart

A

Because if it enlarges we will have pumping problems

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13
Q

What return blood back to right side of heart

A

Vena cava

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14
Q

What are three things that make a heart beat happen

A

Calcium, sodium, potassium

Need to be in adequate supply

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15
Q

Is the mitral valve on the side with high or low pressure?

A

HIGH pressure

Has to have more strength because left side is a higher pressure system

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16
Q

What is mechanical function of the heart measured by

A

Blood pressure, O2 sat, pulse, LOC, oriented

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17
Q

Systole+diastole= _________ function

A

Mechanical

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18
Q

Depolarization and repolarization = _________ function

A

Electrical

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19
Q

When does depolarization happen

A

Just before systole

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20
Q

Electrical firing impulse. Wave of electrical impulse that will trigger contraction

A

Depolarization

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21
Q

Electrical recharging. The myocardial cells recharge and rest after a contraction.. And get ready for the next one

A

Repolarization

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22
Q

What is the heart rate regulated by

A

ANS

autonomic nervous system

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23
Q

What is stroke volume affected by

A

Preload
Afterload
Contractility

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24
Q

What does Frank Starling’s Law say

A

The more the myocardial fibers are stretched, the greater the force of contraction…to a point

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25
Q

What comes first electrical or mechanical activity

A

Electrical activity (depolarization) precedes mechanical activity (systole)

Chemical –> electrical –> mechanical conduction of the heart

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26
Q

CO= ____ x ______

A

CO= SV x HR

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27
Q

Exchange nutrients and metabolic waste

A

Capillaries

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28
Q

ANS= _____ and ______

What happens in the two components

A

ANS= parasympathetic and sympathetic
Parasympathetic- dilates arteries
Sympathetic- increase HR, vasoconstriction, mostly related to afterload

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29
Q

What is the most potent vasoconstrictor in body

A

Aldosterone

-trying to conserve volume

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30
Q

What triggers a response when there is hypovolemia

A

Kidneys

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31
Q

What controls BP min to min and sec to sec

A

Baroreceptors and chemoreceptors

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32
Q

What are baroreceptors sensitive to?

A

Stretch or pressure

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33
Q

What so chemoreceptors respond to

A

Decreased O2
Increased CO2
Decreased pH

Electrolyte content

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34
Q

Pulse pressure=

What increases/decreases?

A

Pulse Pressure= SBP-DBP
Increase- exercise,atherosclerosis
Decreased- hypovolemia, heart failure

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35
Q

Heart failure is also known as

A

Pump failure

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36
Q

The perfusion pressure to bring blood and oxygen to organs in the body

A

Mean Arterial Pressure

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37
Q

If the Mean Arterial Pressure is …
Too high =
Too low=

A

Too high= increased pressure

Too low= underperfused and ischemia

38
Q

What is the pressure exerted on the walls of arteries

A

Arterial BP

39
Q

Stage 2 hypertension criteria

A

SBP > 160

DBP > 100

40
Q

How is arterial pressure elevated

A

By rise in CO or SVR

41
Q

What is the most common cause of HTN

A

Primary HTN

Elevated BP without an identifiable cause

42
Q

Work horse muscle of the heart

A

Left ventricle

43
Q

What do Angiotension II and Aldosterone do in Renin-Angiotension -aldosterone system

A

Angiotension II- potent vasoconstrictor

Aldosterone- sodium retention

44
Q

Complications of HTN

A

Major risk factor for CAD
Left Ventricular Hypertrophy
Heart Failure

45
Q

Symptoms of HTN? When do you see them?

A
  • Rarely symptoms seen until late

- Later symptoms: headache upon awakening, dizziness, visual changes, epitaxis (nose bleeds)

46
Q

What is laminar blood flow

A

Normal blood flow, forward flow through health silky arteries

47
Q

What is turbulent blood flow

A

Intermittent blood flow, clots can develop

48
Q

BUN and Creatinine

A

Kidney function and perfusion

BUN can look at volume how hydrated someone is

49
Q

Cholesterol, serum lipids (HDL, LDL)

A

Lab test for atherosclerosis

50
Q

What can cause high triglyceride levels

A

Alcohol and simple sugars

51
Q

What can a chest x ray show

A

Oxygenation and size of heart

52
Q

What do you use a EKG for

A

Electrical conduction of the heart

53
Q

What is a Echocardiogram

A

Ultrasound to look at chamber and function of the heart

54
Q

What is the first thing you can do for HTN management

A

Lifestyle modifications (diet, exercise)

55
Q

When will you start symptoms with high blood pressure

A

Stage 2 hypertension
SBP > 160
DBP > 100
First symptom could be a headache

56
Q

Normal circulating blood volume is where?

A

Intravascular

57
Q

What space may you see circulating blood volume if a person has fluid? Where should it be?

A

You may see it in interstitial spaces instead of normal intravascular

58
Q

What can high BP over a long period of time cause

A

Retinal damage

59
Q

What is hallmark of Primary HTN

A

Persistent increased SVR

60
Q

What is it called when you can actually feel turbulent of blood flow

A

Thrill

61
Q

What do diuretics deal with

A

Preload
They help get rid of circulating volume
Act on kidneys

62
Q

Examples of loop diuretics

A

Lasix

Bumex

63
Q

Are thiazides or loop diuretics more potent

A

Loop diuretics

64
Q

What do loop diuretics do

A

Prevent reabsorption of Na & Cl

Potassium depleting

65
Q

Examples of thiazides

A

Diuril and Zaroxolyn

66
Q

What must you have to use thiazides

A

Must have good kidney function

67
Q

With a decrease BP or cardiac output what neurological symptoms would you see? What would be effected?

A

Brain is effected
Dizziness, light headedness, change in LOC, diaphoresis, pale

The brain has to have constant supply because it stores nothing

68
Q

What is an example of a K+ sparing diuretic

A

Aldactone

69
Q

What are some characteristics of Aldactone

A

Act on collecting duct
Weak diuretic
Does NOT deplete potassium
Long term maintenance only

70
Q

Who is somebody you would use a K+ sparing diuretic on

A

Cardiac pts or renal failure

They already have something major going on. Trying to control electrolytes

71
Q

What do ARBs deal with?

A

Afterload

72
Q

What is the most potent vasoconstrictor in the body

A

Angiotension II

73
Q

Suffix for ARBs

A

saratan

74
Q

Who is somebody you would give ACE inhibitor to?

A

Diabetics to protect their kidney

Even when BP is normal they are given in a protective way

75
Q

Suffix for Ace inhibitor

A

pril

76
Q

Side effects of ACE inhibitor

A

Dry cough, K+ retention

77
Q

What do beta blockers deal with

A

Afterload

They block effects of increased workload on the heart

78
Q

What may sudden withdraw of beta blockers cause

A

Rebound HTN

79
Q

What do calcium channel blockers deal with

A

Afterload

They cause vasodilation by decreasing entry of Ca and relaxing smooth muscle cells that surround the arteries

80
Q

Common side effect of calcium channel blockers

A

Constipation

81
Q

How long does it take to see a drop in BP after taking a oral dose of a calcium channel blocker

A

30 min

82
Q

What could hypertensive crisis lead to

A

Massive heart attack or stroke from high pressure

83
Q

What is a lab test that you could see increased with a dehydrated patient

A

BUN

84
Q

Normal BUN

A

10-20

85
Q

Normal Creatinine

A

Less than 2

86
Q

Normal Serum potassium

A

3.5-5.5

87
Q

What are symptoms of hypertensive crisis related to

A

Perfusion

88
Q

BP to be classified as a hypertensive crisis

A

SBP > 250

DBP > 140

89
Q

Characteristics of hypertensive crisis

A 
Severe headache or dizziness 
Confusion/seizure/coma
Blurred vision
Nausea or vomiting
Chest pain / sob 
Epitaxis
90
Q

What are foods high in potassium

A

Bananas and dark green leafy vegetables

91
Q

Drug of choice for hypertensive crisis? How do you give it?

A

Nipride

Given slowly because you want to slowly reduce the high pressure. The brain cannot handle huge changes in pressure

92
Q

What are two important things to remember about treating a patient in a hypertensive crisis

A

Give everything through an IV and get oxygen on immediately

Also, have crash cart ready

Nursing Test 3 (10 decks)

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