Hypertension

Question 1

High pressure/tension in the arteries

Answer 1

Hypertension

Question 2

Pre-hypertension values:

Answer 2

120-139/80-89

Question 3

Hypertension Values

Answer 3

140/90 or greater

Question 4

What race has the highest incidences of HTN?

Answer 4

African Americans; have higher rates and develop earlier in life

Question 5

Primary hypertension etiology (cause)

Answer 5

No known cause - may be more directly related to LIFESTYLE choices

Question 6

Secondary Hypertension

Answer 6

Due to a specific cause

Ex. Endocrine disorders, sleep apnea, drug use (esp cocaine)

Question 7

Risk factors for Primary Hypertension (HTN)

Answer 7

Lifestyle - alcohol, tobacco, high cholesterol, high sodium, obesity
Conditions - Diabetes, stress
Others - age, SES, educational background, ethnicity

Question 8

S/S HTN

Answer 8

“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

Question 9

Complications of hypertension are related to

Answer 9

Plaque build up in the arteries which lead to a decrease in perfusion

Question 10

Diagnostic Studies for HTN

Answer 10

Labs to rule out secondary HTN, look at target organ disease, baseline levels
Screen for renal involvement
Electrolytes
Glucose; Cholesterol; ECG

Question 11

Lifestyle modifications for Hypertension

Answer 11

Weight Reduction; Nutrition (low sodium, low fat); Limit alcohol; Exercise; Smoking Cessation; Stress Management

Question 12

Care for Hypertension

Answer 12

Medication therapy

Question 13

Goals for Med Therapy for HTN

Answer 13

Decrease preload (volume of blood circulating)
Decrease Afterload (systemic vascular resistance)

Question 14

Examples of Medications For HTN

Answer 14

Diuretics
Adrenergic Inhibitors
Vasodilators
ACE Inhibitors
Calcium Channel Blockers

Question 15

Possible nursing diagnoses for HTN

Answer 15

Risk for ineffective tissue perfusion r/t complications of HTN
Ineffective Therapeutic Regimen r/t lack of knowledge

Question 16

What is a hypertensive crisis

Answer 16

BP is severely elevated

Question 17

Causes of hypertensive crisis

Answer 17

PT not taking meds (most common)
Drug use
Head injuries

Question 18

Difference between hypertensive emergency and hypertensive urgency

Answer 18

Hypertensive emergency = hours to day w/ tissue organ disease;
Hypertensive Urgency = days to weeks and no evidence of tissue organ disease

Question 19

Manifestations of hypertensive emergency

Answer 19

Hypertensive encephalopathy

Question 20

Hypertensive encephalopathy

Answer 20

Severe headache; N/V; Seizures; Confusion; Coma; Blurred Vision

Question 21

Hypertensive Crisis: Nursing Care

Answer 21

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

Question 22

Why do you not want to lower BP quickly during a hypertensive crisis?

Answer 22

If BP is lowered too quickly it can increase the pt’s risk for stroke

Question 23

Other Nursing Care for hypertensive crisis

Answer 23

ECG, heart monitor, blood tests 
check renal status
Check neuro status
Thorough history 
IV admin antihypertensives ( watch thiocynate levels)