Hypertension (Online Lecture) Flashcards by Lani Manners

if you appropriately manage hypertension the risk is

the same as if you did not have hypertension

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hypertension is
under or over reported

under

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what might trigger a patient to seek treatment and will ultimately be diagnosed with hypertension

target organs

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what are the target organs

eyes
brain
heart
peripheral
vascular
kidney

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what are some examples of changes in the
eyes

blurred vision
blindness

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what are some examples of changes in the
brain

TIA
stroke
dizziness
headache

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what are some examples of changes in the
heart

MI
left ventricular hypertrophy
shortness of breath while up
heart failure

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what are some examples of changes in the
kidney

nocturia
renal failure

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what are some examples of changes in the
peripheral

perisperhal arterial disease

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to diagnosis hypertension

blood pressure measurements done 2 Dif times in 2 Dif visits 1-4 weeks apart

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normal BP

less than 120
and
less than 80

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prehypertensive BP

120-139
or
80-89

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stage 1 hypertension

140-159
or
90-99

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stage 2 hypertension

greater or equal to 160
or
greater or equal to 100

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primary hypertension

high blood pressure from an undetermined cause

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secondary hypertension

high blood pressure with an identifiable cause

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how do we manage secondary hypertension

treat secondary cause in hopes to fix blood pressure

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what are some causes of secondary hypertension

renal parenchymal disease
hyperaldosteronism
medications (steroids, prednisone, epoetin)
coarctation of the aorta
pregnancy
sleep apnea

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risk factors
modifiable

obesity
diet
sedentary lifestyle
alcohol consumption
smoking
OSA

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risk factors
nonmodifiable

ethnicity
age
genetics

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does hypertension normally have symptoms

no
normally asymptomatic

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hypertension nick name

silent killer

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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

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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