Hypertension Flashcards
Hypertension
- systolic: ≥ 130
- diastolic: ≥ 80
Elevated BP
120-129 (sys) and <80 (dia)
Stage 1 HTN
130-139 or 80-89
Stage 2 HTN
≥140 or ≥90
Isolated systolic HTN
> 130 and < 80
-common in >50 yrs
Primary HTN
- stress & increased SNS
- insulin resistance & hyperinsulinemia
- endothelial cell dysfunction
- altered renin-angiotensin
Primary causes
- environmental/demographic/genetic
- water & sodium retension
Age Risks for primary
- > 50 yrs old SBP more vital (CVD)
- normotensive at 55
Secondary HTN
elevated BP with a specific cause
HTN Manifestations
- mostly asymptomatic
- fatigue
- dizziness
- palpitations, angina
- dyspnea
HTN complications
- heart disease
- cerebrovascular disease
- peripheral vascular disease
- nephrosclerosis
- retinal damage
HTN Diagnostics
- urinalysis & uric acid
- ECG
- basic metabolic panel
- CBC
- lipid profile
HTN Lifestyle modifications
- weight loss of 10 kg (22 lb)
- diet rich in veggies, fruit, & nonfat dairy
- <2.3 g of sodium/day
- decrease alcohol (men: 2, women: 1)
- aerobic exercise 30 min
First Line Meds for HTN
- thiazide diuretics
- ACE inhibitors
- ARBs
- calcium channel blockers
Second Line
- loop diuretics
- beta blockers
- alpha 1 blockers
Bumetanide (Bumex)
- loop diuretic
- watch for orthostatic hyptension, dizziness, GI upset
Calcium Channel Blockers
- Very (verapamil) Nice (nifedipine) Drugs (diriazem)
- decrease contractility/conductivity/demand for oxygen
- don’t take with grapefruit
- SE: bradycardia
Ace Inhibitors
- ends with pril
- decrease peripheral vascular
- SE: dizziness, orhtostatic hypotension, first dose syncope
Alpha Blockers
- cardura (blocker), catapres, & aldomet (antagonists)
- SE: orthostatic, vertigo, palpitastions, sexual dysfunction
Beta Blockers
- B1: heart, B2: lungs
- decrease HR/force of contraction/A-V conduction
- inderal, tenormin, lopressor
- SE: bradycardia, hypotension, CHF, lethargy
Nitroglycerin
- vasodilator
- SE: hypotension, tachycardia, dizziness
Older Adults
- white coat HTN
- auscultatory gap
- orthostatic hypo
Hypertensive Crisis
- > 140 DPB
- in patients with history of HTN
- leads to: encephalopathy, ARF, MI, & heart failure
Crisis Care
- IV drug therapy: titrated to mean arterial pressure
- monitor cardiac/renal function
- neuro checks
- determine cause
- education
The nurse teaches a group of patients diagnosed with hypertension that influencing factors related to rising blood pressure are associated with which physiological processes?
- vasoconstriction
- increased blood viscosity
- increased CO
- increased blood volume
The clinic nurse caring for a group of essential hypertension patients understands this disease process is influenced by which contributing factors?
- increased SNS
- increased sodium-retaining hormones
- excessive alcohol intake
The nurse hears the patient state to a family member, “My ears are ringing all the time.” The nurse assesses the patient and reviews the medication record for drugs with the side effect of tinnitus. Which medication(s) is the nurse expecting to find on the medication administration record?
aspirin and furosemide
The nurse recognizes which adverse reaction associated with ACE inhibitors is the most common and typically leads to disruption of therapy?
cough
Spironolactone (aldactone)
potassium sparing diuretic
Losartan (cozaar)
ARB
The nurse anticipates holding which medication for a client with heart rate of 50.
beta blocker
