Hypertension

Question 1

What is the definition of blood pressure?

Answer 1

The pressure/force exerted on the artery walls

The greater the pressure/force, the higher the blood pressure

Question 2

What factors influence and determine blood pressure?

Answer 2

Cardiac Output (stroke volume x heart rate)
Peripheral vascular resistance
Viscosity of the blood
Fluid volume
Sympathetic Nervous System Response
Renin release

Question 3

What body conditions will cause activation of the Renin Angiotensin Aldosterone System (RAAS)?

Answer 3

Decreased blood pressure
Decreased fluid volume
Decreased serum sodium
Decreased renal perfusion
Increased urine sodium

Question 4

What is the purpose of activation of the Renin Angiotensin Aldosterone System (RAAS)? What will result after RAAS activates?

Answer 4

Increased blood pressure
Increased fluid volume
Increased serum sodium
Increased renal perfusion
Decreased urine sodium

Question 5

When should a patient aged 18-29 years old with a “normal” blood pressure (<120/80) report for follow up of a blood pressure?

Answer 5

Every three to five years

Question 6

When should patients aged greater than 39 years old or who are at increased risk for developing HTN report for follow up for a blood pressure?

Answer 6

Annually

Question 7

What type of individuals are at an increased risk for developing HTN?

Answer 7

Those with an elevated blood pressure: Systolic 120-129, Diastolic <80
Those who are overweight
African Americans
Those with a family history of HTN

Question 8

Define primary hypertension

Answer 8

Chronic BP elevation without known cause

Question 9

Define secondary hypertension

Answer 9

Chronic BP elevation due to another issue within the body

Question 10

List signs and symptoms of hypertension

Answer 10

Often no s/s

Rare s/s include: Headache, bloody nose, severe anxiety, dyspnea

Question 11

How can hypertension be diagnosed?

Answer 11

Analyze risk factors (both modifiable and nonmodifiable)
Analyze signs and symptoms
Assess if there is history of kidney diesase
Assess if there is history of heart disease
Evaluate blood pressure readings from home
Current use of medications

Question 12

List modifiable risk factors that have the ability to cause hypertension

Answer 12

Decreased activity level
Smoking
Poor diet
Insufficient sleep
Blood glucose level elevated
Increased weight
Poor stress management 
Diabetes Mellitus Type 2

Question 13

List nonmodifiable risk factors that have the ability to cause hypertension

Answer 13

Family history of HTN
Increased age
Race and Ethnicity
Diabetes Mellitus Type 1

Question 14

What is considered a “normal” blood pressure

Answer 14

<120/80

Question 15

What blood pressure ranges fall under “elevated blood pressure”

Answer 15

Systolic: 120-129
Diastolic: <80

Question 16

What blood pressure ranges fall under “stage one hypertension”

Answer 16

Systolic: 130-139
Diastolic: 80-89

Question 17

What blood pressure ranges fall under “stage two hypertension”

Answer 17

Systolic: > or equal to 140
Diastolic: > or equal to 90

Question 18

List therapeutic meausrements for hypertension control

Answer 18

Modify lifestyle (adjust modifiable risk factors that are present), such as:
Weight reduction
Diet changes: DASH diet, more whole foods, less sugars, less fats, follow Mediterranean diet
Increase physical activity
Stop smoking
Reduce stress
Increase Sleep

Start on antihypertension medications

Question 19

What self care measures must a patient take to control blood pressure?

Answer 19

Decrease stress
Adjust lifestyle
Control modifiable risk factors

Question 20

What education must a patient be provided with when starting on antihypertensive medication?

Answer 20

Medication must be continued even if s/s are not present
Get up slowly
Change positions slowly
Don’t abruptly discontinue medications

Question 21

What vital sign should be assessed before administering any antihypertensive medication?

Answer 21

Blood pressure! Always assess prior to giving a medication that will decrease the blood pressure.

If the medication will alter another vital sign (such as heart rate), this should be assessed as well

Question 22

List all medication drug classes that discussed in class that can be administered to control hypertension

Answer 22

Statin
Loop diuretic
Thiazide diuretic
Potassium sparing diuretic
Angiotensin converting enzyme inhibitor
Angiotensin 2 Receptor blocker
Calcium Channel Blocker
Beta Blocker
Combined Alpha and Beta Blocker
Central Acting Alpha 2 Agonist
Direct Vasodilator

Question 23

List the complications that can occur when hypertension remains unmanaged long term

Answer 23

Atherosclerosis
Coronary artery disease
Myocardial Infarction
Heart Failure
Left Ventricular Hypertrophy
Stoke
Kidney Disease
Retina Damage

Question 24

Which two complications fall under a Hypertensive Crisis

Answer 24

Hypertensive Urgency

Hypertensive Emergency

Question 25

Who is at risk for going into a hypertensive crisis?

Answer 25

A patient who doesn’t adhere to their therapy

A patient who stops their medications abruptly

Question 26

What is more concerning with a hypertensive crisis? The blood pressure reading or the rate of increase of the blood pressure?

Answer 26

The rate of increase of the blood pressure

Question 27

Describe hypertensive urgency

Answer 27

It is a severe elevation of the blood pressure that develops slowly: hours to days
There is no target organ dysfunction
Symptoms may or may not be present (headaches, nosebleeds, SOB, anxiety)

Question 28

How is a hypertensive urgency treated?

Answer 28

Oral medications and follow up

Question 29

Describe hypertensive emergency

Answer 29

It is a severe elevation of the blood pressure that develops rapidly: acute increase in BP
Target organ dysfunction may or has developed during this episode

Question 30

How is a hypertensive emergency treated?

Answer 30

Hospital admission; critical care

BP gradually decreased