Hypertension Flashcards
Final
What is hypertension?
Force of blood against artery walls that is high enough to cause health problems.
What main things are damaged by high blood pressure?
Blood vessels in heart and kidney
What systems is blood pressure regulated by?
Cardio
Endocrine
Renal
Nervous (SNS)
Baroreceptors monitor what?
Stretch pressure
Looking for drop in B/P
Chemoreceptors monitor what?
O2 and CO2
Looking for balance
What is RAAS?
Renin
Angiotensin I-if changes to II, B/P gets too high!
Aldosterone
Blood pressure =
Cardiac output X Vascular resistance
When do the kidney’s release renin?
When B/P if below 100
What is the silent killer?
Hypertension
- Might be asymptomatic
- Damage is still being done
Normal B/P
120/80
Isolated systolic hypertension
> 140 over <90
Prehypertension
120-139 over 80-89
Stage 1 HTN
140-159 over 90-99
Stage 2 HTN
Systolic 160 or higher OR Diastolic 100 or more
*If 180/110-need to be seen immediately!!
High systolic and low diastolic is common in what age group?
Mostly old people
Types of Hypertension
Isolated Systolic Hypertension (ISH)
Primary Hypertension
Secondary Hypertension
What is Isolated Systolic Hypertension (ISH)?
Systolic >140, Diastolic <90
Which type of hypertension is most common?
Isolated Systolic Hypertension (ISH)
Why does Isolated Systolic Hypertension (ISH) effect individuals older than 50?
**Stiff arteries
-deficient baroreceptors
What is Primary hypertension?
Essential or idiopathic hypertension
90-95% of cases
Causes cannot be identified
What is secondary hypertension?
High blood pressure from an identified source
5-10% of cases
Treatment aimed at cause
What is a major cause of blood pressure to go up?
Smoking-vasoconstrictor
Clinical presentation of hypertension
May not have abnormalities
Depends on location of damaged vessels
- EYES
- CAD with angina, MI, HF
- Kidney-edema, proteinuria, renal failure
- CVA, TIA
Clinical manifestations of severe HTN
Dull headaches
- doesn’t go away
- If BAD, could bust a vessel
Dizzy spells
Nosebleeds
-not because of dryness
How to diagnose hypertension
Echocardiogram-structure & action
UA
ECG-heart damage
Blood tests
-BUN, glucose, creatnine, lipid
X-ray or US of kidneys
UA (creatinine clearance)-24 hr refrigerated-kidney damage
Treatment of hypertension
To decrease vascular resistance and blood volume
Control blood pressure=decrease CV risk
*Look at culture: food, activities
Medications for hypertension
Diuretics-volume Adrenergic inhibitors Direct vasodilators Angiotensin inhibitors Calcium channel blockers
*Lipid lowering drugs
OTC hypertension
Nitric oxide-garclic (thins blood)
Probiotics-gut health (where immune system is)
Omega 3-fish oil will make you bleed
Fatty fish=salmon
Nursing info for hypertension
- Don’t pump B/P higher than brachial pulse
- Orthostatic is important! Get pt up slowly!
- Older people may not tolerate a B/P lower than 120/?
What type of problem effects pulse rate?
Pituitary
Lifestyle modifications
- Decrease stroke 35-40%
- Decrease MI 20-25%
- Decrease HF 50%
Dietary can stop HTN
- increase fruits, veggies
- increase carb, fat
Blood pressure is _____ in the morning, and _____ in the evening
higher; lower
Blood pressure _____ with age
rises
- S-until 80
- D-until 55-60
If blood pressure is taken in both arms, use the _______ result
highest
What is hypertensive crisis?
Severe, abrupt increase in diastolic blood pressure (defined as >140)
What is the most important part of hypertensive crisis?
Rate of increase is more important that actual value
*Did it rise quickly or creep up?
What often causes hypertensive crisis?
Patients that have failed to comply with medications, who have been under-medicated, or people who have taken illegal drugs.
Hypertensive crisis clinical manifestations
May look like a stroke, but can still move
Chest pain-can go through to back
180/110-URGENT!
MAP
Mean Arterial Pressure
Good MAP: 70-110.5
If below 60, brain isn’t getting anything.
