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Cardiac > Hypertension > Flashcards

Hypertension Flashcards

1
Q

If a patient has hypertension what are they at major risk for?

A

CHD, heart failure, renal failure, blindness.

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2
Q

What percent of patients are unaware off their condition of hypertension?

A

30%

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3
Q

What percent of patients being treated for hypertension achieve control of their condition?

A

34%

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4
Q

How is hypertension defined?

A

High blood pressure: systolic greater than 140 mm Hg and a diastolic pressure greater than 90 mm Hg.

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5
Q

How many visits to the health care provider as well as accurate blood pressure measurements need to be taken for someone to be diagnosed with hypertension?

A

Two or more.

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6
Q

What is classified as a normal blood pressure?

A

Systolic: less than 120
Diastolic: less than 80

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7
Q

What is classified as prehypertension?

A

Systolic: 120-139
Diastolic: 80-89

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8
Q

What is classified as Stage 1 hypertension?

A

Systolic: 140-159
Diastolic: 90-99

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9
Q

What is classified as Stage 2 hypertension?

A

Systolic: Greater than or equal to 160
Diastolic: Greater than or equal to 100

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10
Q

What is the percent of adults with hypertension that do not have it under control?

A

54%

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11
Q

What ethnicity’s has the highest rate of hypertension?

A

African Americans and Hispanics

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12
Q

How is blood pressure described?

A

For exerted against walls of arteries

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13
Q

How is systolic blood pressure described?

A

Highest pressure at peak of ventricular contraction

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14
Q

How is diastolic blood pressure described?

A

Lowest pressure exerted during ventricular relaxation

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15
Q

What are the three elements that determine blood pressure?

A

Heart rate, stroke volume, and total peripheral resistance

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16
Q

How is stroke volume described?

A

Amount of blood that is pumped out of the ventricle with each heart beat.

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17
Q

How is total peripheral resistance described?

A

Resistance of the muscular arteries to the blood being pumped through

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18
Q

True or false:

The weaker the resistance in the arteries the higher the blood pressure?

A

False:

The greater the resistance the in the arteries the higher the blood pressure.

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19
Q

What part of the nervous system plays a role in controlling peripheral resistance?

A

Autonomic Nervous System

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20
Q

When taking medications that affect the vascular smooth muscles what can occur to the BP?

A

It may lower or raise it.

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21
Q

Which part of the nervous system affects the arterial blood pressure when stimulation is increased?

A

The sympathetic nervous system.

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22
Q

Increased activity of this system influences arterial blood pressure.

A

The Renin-angiotensin-aldosterone system.

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23
Q

Increased activity of this hormone and its synthetic version influence arteriole blood pressure.

A

Anti-diuretic hormone/ Vasopressin

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24
Q

True or False:

The resistance to insulin action does not influence arterial blood pressure.

A

False:

It does affect arterial blood pressure.

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25
Q

What is arteriosclerosis?

A

The hardening of the arteries

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26
Q

What is atherosclerosis?

A

Plaque accumulation

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27
Q

What does the extent of arteriosclerosis and atherosclerosis influence?

A

Arterial Blood Pressure

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28
Q

What types of changes affect arterial blood pressure in the elderly?

A

Structural and functional changes in the heart, blood vessels, and kidneys.

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29
Q

What percent of hypertension patients are affected by primary hypertension?

A

90%

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30
Q

What percent of hypertension patients are affected by secondary hypertension?

A

10%

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31
Q

How is primary hypertension described?

A

Persistently elevated systemic blood pressure.

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32
Q

Overstimulation of these receptors can result in primary hypertension.

A

Alpha and beta adrenergic receptors

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33
Q

Altered function of this system can result in primary hypertension.

A

Renin-angiotensin- aldosterone system

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34
Q

The function of this can result in primary hypertension.

A

Endothelial function

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35
Q

True or false:

Insulin resistance and hyperinsulinemia can result in primary hypertension?

A

True

36
Q

How is secondary hypertension described?

A

Elevated blood pressure from an identified cause.

37
Q

These two disorders can lead to hypertension.

A

Endocrine and neurological disorders

38
Q

When this happens to the aorta this can lead to secondary hypertension.

A

Coarctation

39
Q

How is coarctation of the aorta described?

A

A congenital condition where the aorta is narrow.

40
Q

What disease can lead to secondary hypertension?

A

Kidney disease

41
Q

True or false:

Drug use and pregnancy can lead to secondary hypertension?

A

True

42
Q

What is a patients blood pressure during a hypertensive emergency?

A

Systolic: Greater than 180 mm Hg
Diastolic: Greater than 120 mm Hg

43
Q

If a hypertensive emergency is prolonged what organ failure can it lead to?

A

Renal (kidney)

44
Q

What 5 clinical manifestations occur during hypertensive encephalopathy?

A
  • Extremely high BP
  • Altered level of consciousness
  • Increased inter cranial pressure
  • Papilledema
  • Seizures
45
Q

How soon do you need to treat a hypertensive emergency?

A

Within 1 hour

46
Q

What is the name for a hypertensive emergency?

A

Malignant Hypertension

47
Q

What age group is typically affected by Malignant Hypertension?

A

Middle aged and older adults

48
Q

What ethnicity’s have a higher chance of getting Malignant Hypertension?

A

African Americans, Native Americans, and Alaskan Natives.

49
Q

What 3 nonmodifiable risk factors can lead to Malignant Hypertension?

A

Genetic factors, age, race

50
Q

What behavioral modification can be made to lower your risk of Malignant Hypertension?

A

Lowering sodium intake, increasing potassium, calcium and magnesium intake.

51
Q

Obesity, insulin resistance, excess alcohol consumption, sedentary lifestyle, smoking, and stress are all risk factors of this malignant condition.

A

Malignant hypertension

52
Q

These four organs are affected by untreated hypertension.

A

Heart, brain, kidneys, and retina.

53
Q

Should the nurse take blood pressure from each arm to gain an accurate baseline for a patient with hypertension?

A

Yes

54
Q

What type specimens should the nurse take from a patient with hypertension?

A

Blood and urine

55
Q

What 3 things should to nurse ask when acquiring a health history of a hypertensive patient other than current medications and family history?

A

Headache or neck pain
Heart or renal disease
Diabetes

56
Q

What three things should the nurse pay attention to during the physical examination of a hypertensive patient?

A
  • Vital Signs
  • Peripheral pulses
  • Ophthalmological exam
57
Q

If the diastolic is high what can you assume is going on in the heart?

A

It is working too hard. The diastolic pressure is supposed to be at rest.

58
Q

True or false:
People who are on medication for hypertension and have it under control are still at risk for pressure related damage to their organs?

A

False.
A patient who has controlled hypertension through medication are not at a greater risk that a person who is normotensive.

59
Q

How is peripheral resistance defined?

A

Friction in the arteries as blood flows through the vascular system.

60
Q

The greater the peripheral resistance means what to the BP?

A

A greater BP

61
Q

A higher stroke volume means what to the BP?

A

A higher BP

62
Q

What do ACE inhibitors do and how does it affect a hypertensive patient?

A

They keep angiotensin I from converting to angiotensin II. This keeps their BP under control.

63
Q

How is preload described?

A

The blood going into the heart

64
Q

How is after load described?

A

The blood leaving the heart

65
Q

Should the preload and after load be fairly similar?

A

Yes

66
Q

What is a classic sign that a person may exhibit if they have hypertension?

A

Nocturia- increased urination at night

67
Q

How does salt affect blood pressure?

A

Increased salt intake leads to water retention. This causes edema which increases the blood pressure.

68
Q

This is the reason the target organs are affected by hypertension.

A

increased pressure.

69
Q

How do you take an orthostatic blood pressure?

A

You take the blood pressure of the patient while they are laying down, then while they are sitting with their feet dangling, then while they stand.

70
Q

In terms of retinal changes: what would a patient describe that would make you think they could be hypertensive and why?

A

Eye tiredness and blurry vision. These could be caused by increased pressure on the retina.

71
Q

What are the two clinical manifestations that would suggest a patient has accelerated atherosclerosis?

A

A cerebral vascular accident (CVA) or a myocardial infarction (MI)

72
Q

What 3 lab tests suggest that a patient has renal insufficiency due to hypertension?

A

BUN, creatinine, and renin levels.

73
Q

What is the DASH diet?

A

Dietary Approach to Stop Hypertension

74
Q

What is the main goal of a DASH diet?

A

Reduce salt intake

75
Q

If a patient looses this many pounds they could see a BP decrease.

A

10

76
Q

Patient with hypertension should not have more than how many ounces or drinks of alcohol per day?

A

1 oz ethanol or 2 drinks per day

77
Q

True or false:

Women with hypertension can consume more alcohol than men.

A

False:

They should consume less.

78
Q

Why should patients with hypertension not smoke?

A

It causes poor circulation and can lead to heart disease.

79
Q

What are the four behavioral and mind-body therapies a patient can use to reduce stress?

A
  • Yoga
  • Tai chi
  • Meditation
  • Guided imagery
80
Q

What is the usual initial treatment for a patient with hypertension?

A

Thiazide diuretic

81
Q

What type of dose is given to a patient who is initially diagnosed with hypertension and what do they do to it if the targeted blood pressure goal is not reached?

A

A low dose is initiated and gradually increased until the goal is met.

82
Q

True or false:

After a patient begins blood pressure medication they can revert to their old lifestyle habits?

A

False:

Lifestyle changes initiated to control blood pressure must be maintained.

83
Q

Increased urine output does what to blood pressure?

A

It decreases blood pressure.

84
Q

What is the nurse’s main goal when treating a patient with hypertension?

A

To promote health maintenance

85
Q

What are the three type of logs a patient should maintain while trying to reduce their hypertension?

A

BP checks with log, daily weight log, food log

86
Q

Why would you choose a monotherapy for an elderly patient?

A

To simplify the medication regimen and make it less expensive.

87
Q

What do you need to make sure the elderly patient can understand and do in terms of their medication regimen?

A

That they understand the regimen, they can see and read the instructions, open the medication containers and get their prescriptions refilled.

Cardiac (13 decks)

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