Hypertension Flashcards
High pressure/tension in the arteries
Hypertension
Pre-hypertension values:
120-139/80-89
Hypertension Values
140/90 or greater
What race has the highest incidences of HTN?
African Americans; have higher rates and develop earlier in life
Primary hypertension etiology (cause)
No known cause - may be more directly related to LIFESTYLE choices
Secondary Hypertension
Due to a specific cause
Ex. Endocrine disorders, sleep apnea, drug use (esp cocaine)
Risk factors for Primary Hypertension (HTN)
Lifestyle - alcohol, tobacco, high cholesterol, high sodium, obesity
Conditions - Diabetes, stress
Others - age, SES, educational background, ethnicity
S/S HTN
“Silent killer” - s/s don’t present until organ damage is being done
S/S are r/t workload on heart and effect on tissues: fatigue; dizziness; palpitations; angina; dyspnea
Complications of hypertension are related to
Plaque build up in the arteries which lead to a decrease in perfusion
Diagnostic Studies for HTN
Labs to rule out secondary HTN, look at target organ disease, baseline levels
Screen for renal involvement
Electrolytes
Glucose; Cholesterol; ECG
Lifestyle modifications for Hypertension
Weight Reduction; Nutrition (low sodium, low fat); Limit alcohol; Exercise; Smoking Cessation; Stress Management
Care for Hypertension
Medication therapy
Goals for Med Therapy for HTN
Decrease preload (volume of blood circulating) Decrease Afterload (systemic vascular resistance)
Examples of Medications For HTN
Diuretics Adrenergic Inhibitors Vasodilators ACE Inhibitors Calcium Channel Blockers
Possible nursing diagnoses for HTN
Risk for ineffective tissue perfusion r/t complications of HTN
Ineffective Therapeutic Regimen r/t lack of knowledge
What is a hypertensive crisis
BP is severely elevated
Causes of hypertensive crisis
PT not taking meds (most common)
Drug use
Head injuries
Difference between hypertensive emergency and hypertensive urgency
Hypertensive emergency = hours to day w/ tissue organ disease;
Hypertensive Urgency = days to weeks and no evidence of tissue organ disease
Manifestations of hypertensive emergency
Hypertensive encephalopathy
Hypertensive encephalopathy
Severe headache; N/V; Seizures; Confusion; Coma; Blurred Vision
Hypertensive Crisis: Nursing Care
Blood pressure checks - q15min
Lower BP Gradually (20-25% dec in MAP or 110-115mmHg)
Medication: IV Nicardipine (Ca Channel Blocker); IV Sodium Nitroprusside - Both lower BP
Why do you not want to lower BP quickly during a hypertensive crisis?
If BP is lowered too quickly it can increase the pt’s risk for stroke
Other Nursing Care for hypertensive crisis
ECG, heart monitor, blood tests check renal status Check neuro status Thorough history IV admin antihypertensives ( watch thiocynate levels)
