Hypertension FINAL Flashcards
How to calculate MAP
SBP + (2xDBP)
then divide by 3
MAP is the mean (average) arterial pressure during a cardiac cycle. It is an indicator of
organ perfusion
> 60 mmHg is enough to sustain the organs of an avg. person
< 60 organs are not perfused and will eventually become ischemic
Strength of blood pushing against the sides of arteries. Influenced by cardiac output (CO) & systemic peripheral vascular resistance (PVR)
Blood pressure (BP)
Average BP that is higher than normal over a period of time consisting of two or more office visits
Hypertension
Indicates the health and tone of arterial walls
pulse pressure
High Blood Pressure is usually __________. Present for years without discovery, meanwhile doing damage to organs. AKA the “silent killer”
asymptomatic
Decrease in BP by 20 mmHg systolic and/or 10 mmHg diastolic
orthostatic hypotension
S3 heart sound
“Kentucky”, Ventricular Gallop, Normal in elderly, pregnant, and adolescent/athletes
ABNORMAL–> Systolic HF
S4 heart sound
“Tennessee”, Atrial Gallop, Almost ALWAYS pathological, Stiff Ventricle, diastolic dysfunction
ABNORMAL–> Left ventricular hypertrophy
Primary HTN
Chronic elevation in BP that occurs without disease. Can be diastolic, systolic, or both. Results in damage to vital organs & causes thickening of arterioles.
Secondary HTN
caused by underlying health problem
Nonmodifiable risk factors
- Age: develops 30-50yo
- Gender: Men <55, Women >55
- Ethnicity: African American
- Family Hx: Parent or Siblings w/HTN
Modifiable risk factors
- Obesity
- Stress
- Substance abuse
- Excess Na & water retention
- Elevated Lipids: Triglycerides and Cholesterol
- Sedentary Lifestyle
- Diabetes: blood vessel disease in HTN
- Diet: increased sat fats & salt –> plaque buildup
Diagnostics of HTN
-serial BP readings
-cholesterol levels
-microalbuminuria
Monitor for hypotension when using all HTN drugs
True or False
True
If patient has a persistent, dry cough when on ACEi, switch to
ARBs
Adverse effect of Garlic & Coenzyme Q10
bleeding and liver damage
Hold beta blockers when
HR <50-60 and SBP <90-100
What fruit should be avoided when taking calcium channel blockers?
grapefruit
Assess dehydration & electrolyte imbalance when patient is taking
diuretics
Side effects of Loop & Thiazide medications
HYPOkalemia (life-threatening dysrhythmias)
HYPOmagnesemia
K sparing medications can cause __________ and the patient should avoid foods high in potassium.
HYPERkalemia–> Life Threatening dysrhythmias
What meds?
o Allergic Rxn: Angioedema
o Assess for Hyperkalemia
o Hold for SBP <100
ACEi & ARBs
No ACEi and ARBs in women who are
pregnant or planning pregnancy
Palpating each carotid separately prevents
blocking perfusion to the brain
Temp. differences in lower extremities and cap. refill is an indicator of
poor perfusion
Target BP for pts w/ and w/o diabetes
w/ diabetes - BP <130/90 mm/Hg
w/o diabetes - BP <120/80 mm/Hg
Consequences of high BP
stroke, vision loss, heart attack, heart failure, erectile dysfunction, kidney disease/failure
What is the most important goal for someone with HTN?
Commitment to long term therapy
Lab goals re: cholesterol
Cholesterol <200 mg/dL
LDL <70 mg/dL
HDL >40 mg/dL
Triglycerides <150 mg/dL
HgA1C 6%
BS <130 mg/dL
There is strong evidence for a relationship between high salt intake and increased blood pressure. Reduce salt added when preparing foods, and at the table. Avoid or limit consumption of high salt foods such as soy sauce, fast foods and processed food including breads and cereals high in salt. What is the restriction/limit of salt consumption?
Na restriction is usually no more than 2400 mg/day, preferred limit of 1500mg/day.
Avoid salt substitutes
What is the recommended daily limit for alcohol consumption?
The recommended daily limit for alcohol consumptions is 2 standard drinks for men and 1.5 for women.
Avoid binge drinking.
Strategies to lower BP
salt reduction, healthy diet & drinks, moderation of alcohol consumption, weight reduction, smoking cessation, regular physical activity, and reduce stress
