Hypertension (Online Lecture) Flashcards
if you appropriately manage hypertension the risk is
the same as if you did not have hypertension
hypertension is
under or over reported
under
what might trigger a patient to seek treatment and will ultimately be diagnosed with hypertension
target organs
what are the target organs
eyes
brain
heart
peripheral
vascular
kidney
what are some examples of changes in the
eyes
blurred vision
blindness
what are some examples of changes in the
brain
TIA
stroke
dizziness
headache
what are some examples of changes in the
heart
MI
left ventricular hypertrophy
shortness of breath while up
heart failure
what are some examples of changes in the
kidney
nocturia
renal failure
what are some examples of changes in the
peripheral
perisperhal arterial disease
to diagnosis hypertension
blood pressure measurements done 2 Dif times in 2 Dif visits 1-4 weeks apart
normal BP
less than 120
and
less than 80
prehypertensive BP
120-139
or
80-89
stage 1 hypertension
140-159
or
90-99
stage 2 hypertension
greater or equal to 160
or
greater or equal to 100
primary hypertension
high blood pressure from an undetermined cause
secondary hypertension
high blood pressure with an identifiable cause
how do we manage secondary hypertension
treat secondary cause in hopes to fix blood pressure
what are some causes of secondary hypertension
renal parenchymal disease
hyperaldosteronism
medications (steroids, prednisone, epoetin)
coarctation of the aorta
pregnancy
sleep apnea
risk factors
modifiable
obesity
diet
sedentary lifestyle
alcohol consumption
smoking
OSA
risk factors
nonmodifiable
ethnicity
age
genetics
does hypertension normally have symptoms
no
normally asymptomatic
hypertension nick name
silent killer
because hypertension is asymptomatic how does this relate to medication adherence
people do not want to take medications because they were not having side effects and the medications often cause negative side effects
when signs and symptoms of target organs start to occur, what does this mean
indicative of vascular damage
assessment and diagnostics to asses target organ damage
NA, K, fasting glucose, BUN, CR
kidney function
assessment and diagnostics to asses target organ damage
urinalysis
kidney function
assessment and diagnostics to asses target organ damage
12 lead ECG
heart function
post MI
assessment and diagnostics to asses target organ damage
2D echo
left ventricular hypertrophy
risk factors for CV DISEASE in patients with hypertension
smoking
obesity
diabetes
physical inactivity
impaired renal function
age
family history
dyslipidemia
medical management goal
less than 140/90
medical management
optimal treatment plan is
inexpensive
simple
least disruptive
what is the start for treatment
lifestyle modifications
what if you are prescribed medications? do you still need to do lifestyle modifications
yes
what are some lifestyle changes
weight loss
DASH
physical activity
moderate alcohol consumption
what are some pharmacological treatments
ACE/ARB
diuretics
beta blockers
combination
what is pharmacological treatments goal
decrease peripheral resistance
blood volume
strength and rate of myocardial contraction
ACE ending
PRIL
ARB ending
SARTAN
how do ACE and ARB work
in the RAAS
decrease peripheral vascular resistance
diuretics ending
MIDE
THIAZIDE
ONE
what do diuretics do
decrease blood volume/pressure
beta blockers ending
OLOL
what do beta blockers do
slow HR, decrease BP
what is important to watch for in beta blocker
heart rate
what is important to watch for in ACE/ARB/diuretics
kidney function
what is important for discontinuing any of these meds
taper
what is important to watch for when on these medications
orthostatic hypotension
possible risk for falls
how do we manage doses in these medications
increase gradually until target BP is met
too small of cuff
increase BP
too big of cuff
decrease BP
how do we get an accurate BP
sitting quietly for 5 mins, arm at heart level, feet flat and uncrossed, avoid talking, not smoking or consumed caffeine in 30 mins
nursing diagnoses
deficient knowledge regarding the relation between the treatment regimen and control of the disease process
noncompliance with therapeutic regiment related to side effects of prescribed therapy
how do we promote adherence to treatment
compromises may be necessary
supporting in the small changes
support groups
elderly: medication regimen can be __________ to remember
difficult
elderly: at risk for
orthostatic hypotension
elderly: at risk for what related to diuretic therapy
volume depletion
what type of therapy do we want to target
monotherapy
- simplify
- less expensive
elderly: make sure they can
see and read instructions
open medication containers
get prescriptions filled
