Hypertension

Question 1

Hypertension is accompanied by…

Answer 1

high LDL, low HDL, obesity, diabetes, sedentary lifestyle, sleep apnea, family history

it can result from increased cardiac output and increased peripheral resistance

Question 2

prolonged blood pressure gradually does what

Answer 2

damages blood vessels, particularly in target organs like heart, kidneys, brain and eyes.

Question 3

As the heart works harder to pump blood against elevated pressure what might occur?

Answer 3

hypertrophy of the left ventricle

Question 4

primary hypertension is also called

Answer 4

essential hypertension

it is defined as…?? high blood pressure from an unidentified cause

Question 5

secondary hypertension is

Answer 5

when the result of high blood pressure CAN be identified.

Causes are..? narrowing of renal arteries, certain medications like prednisone, parenchymal disease

Question 6

clinical manifestations of hypertension

Answer 6

there may be retinal changes like hemorrhages, ateriolar narrowing, cotton wool spots (tissue death due to oxygen), papilledema, renal damage, elevated BUN and creatinine.

Question 7

consequences of hypertension

Answer 7

MI, and CAD with angina

Question 8

hypertensive emergency

Answer 8

blood pressure of 180/120, acute and life threatening, damages target organs.

Question 9

what is the goal of therapy for hypertensive emergencies?

Answer 9

reduce the blood pressure by 20-35% within the first hour.

Reduce the blood pressure to 160/100 over a period of 6 hours.

Reducing blood pressure too fast can cause ORGAN HYPOPERFUSION!

Question 10

what is considered a hypertensive urgency

Answer 10

situation in which blood pressure is very high but it does not affect target organs. it is associated with headaches, nosebleeds, and anxiety. Oral agents can be administered with the goal of normalizing BP in 24/48 hours.

Question 11

risk factors for hypertension

Answer 11

smoking, drinking, diabetes, impaired renal function, obesity, physical inactivity, family history

Question 12

DASH diet

Answer 12

consume diet rich in fruits, veggies, low fat dairy products and reduce saturated and total fats as well as sodium

Question 13

lifestyle modifications for hypertension

Answer 13

Weight reduction: normal BMI of 18.5 to 25

reduce sodium: use spices instead. intake of salt should be

Question 14

patient education for hypertension

Answer 14

1. ) it would be important to consult a dietitian
2. ) it takes 2 to 3 mo. for taste buds to adapt to changes in salt intake
3. ) limit alcohol consumption and tobacco should be avoided
4. ) emphasize control rather than cure
5. ) take meds same time everyday, do not skip doses

Question 15

What is rebound hypertension?

Answer 15

occurs if antihypertensive meds are suddenly stopped such as when traveling.

Question 16

hypertension can be a sign for

Answer 16

atherosclerotic cardiovascular disease

Question 17

changes that contribute to increases in blood pressure that occur with aging

Answer 17

decrease in elasticity of vessels, accumulation of atherosclerotic plaque, fragmentation of arterial elastins, increased collagen deposits, impaired vasodilation, renal dysfunction.

Question 18

what is elevated systolic pressure without a change in diastolic pressure/?

Answer 18

isolated systolic hypertension

occurs in older adults when the aorta and large arteries are less able to accommodate the blood volume being pumped out of the heart, and the energy that would have stretched the vessels instead elevates the systolic pressure.

Question 19

what are some routine lab tests for diagnosing hypertension

Answer 19

urinalysis, blood chemistry (creatinine, sodium, potassium, fasting glucose and total HDL cholesterol levels) 12 lead ECG to find left ventricular hypertrophy and examining the retinas

Question 20

JNC7 specified a lower goal pressure of what for people who have diabetes or kidney disease?

Answer 20

130/80

Question 21

recommended initial medications for hypertension

Answer 21

beta blockers and diuretics

Question 22

when taking blood pressure, using a cuff that is too small can result in

Answer 22

a blood pressure reading that is falsely high

Question 23

what time frame should you take blood pressure in a patient who’s blood pressure is changing rapidly

Answer 23

every 5 minutes

every 15-30 min for a patient who is more stable