Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N5160 > Hypertensive Emergencies > Flashcards

Hypertensive Emergencies Flashcards

1
Q

Hypertensive crisis is defined as SBP > _______ or DBP >________

A

180mmHg; 120 mm HG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pts with acute elevation in BP levels and do not demonstrate acute end-organ damage are diagnosed with __________

A

Hypertensive urgency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pts with acute elevation in BP levels and DO demonstrate life threatening acute end-organ failure are diagnosed with _______________ and will require ______ ________

A

Hypertensive crisis or emergency ; IV medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute end organ damage can manifest as ______,_______, ________, ______, ______,_____, ____________, _______

A

Encephalopathy; ischemic and hemorrhagic strokes; Acute aortic dissection; ACS; HF; Pulmonary edema or resp failure; ARF; HELLP (hemolysis, elevated liver enzymes, low platelets) preeclampsia or eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pt with labile BP should be monitored in _____ and ________ ____ ______ monitoring

A

ICU; intra-arterial BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oral therapy should be used in patients with _________ ______with a goal of obtaining a gradual lowering of BP levels by ____% over ___ to ___ hours

A

Hypertensive urgency; 20; 24; 48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If IV therapy is given to patient with ________with no evidence of end organ damage, the rapid reduction in BP may lead to ________ and _____ to organs that had become dependent on the increased blood flow.

A

hypertensive urgency; ischemia and infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

IV forms of medication used in hypertensive emergencies should have _____onset and _____duration

A

fast; short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

IM and SL in hypertensive emergencies should be avoided because they lack the ability to be ______ and may lead to _______ ______ ______ levels

A

titrated; unpredictable drop in BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Goal of BP reduction in hypertensive emergency should be _____ to _____ % in ____In the first ____ to _____ minutes; And in ______ ________ ______, the reduction should occur in less than ___ to ___ minutes , targeting a SBP of less than ______ and MAP less than ________

A

10-15; DBP; 30-60; ascending aortic dissection; 5-10; 120 <80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rapid reduction in BP slow __________

A

progression of end organ damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Drugs meeting ideal characteristics for the management of Hypertensive crisis or emergency are _____ ____ ____ _____

A

labetalol, esmolol, nicardipine and fenoldopam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Esmolol is a _________ (cardioselective or non-cardioselective, ____adrenergic blocker without peripheral _____blocking activity and therefore no ______effects

A

cardioselective; Beta; Alpha; vasodilatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

For acute aortic dissection the recommended agent to decrease BP is _______. A combination of ______ and a ________ is recommended.

A

labetalol.; beta blocker; vasodilator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

For acute ischemic stroke or intracerebral bleed, the recommended agent to decrease BP is _________

A

Nicardipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

For Acute MI, the recommended agent to decrease BP is _________

A

Labetalol plus nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute pulm edema/ DIASTOLIC Dysfunction, the recommended agents to decrease BP is ______ plus _______ + _______

A

Esmolol Plus nitroglycerin + Loop diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acute pulm edema/ SYSTOLIC Dysfunction agents to decrease BP is ______ plus _______ + _______

A

Nicardipine Plus nitroglycerin + Loop diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Contraindicated in pregnancy are ______ and ______

A

Nitroprusside and ACEI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Enalaprilat electrolyte imbalance _________(possible)

A

hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

For ______monitor serum potassium every 6 h during infusion

A

Fenoldopam

22
Q

Adverse effects of Esmolol

A

Thromophlebitis extravasation

23
Q

Is hydralazine safe in pregnancy? Adverse effect:_________other medications with that adverse effect are __________ and ______

A

Yes ; Reflex tachycardia; nicardipine; nitroglycerin

24
Q

Is labetalol safe in pregnancy? Adverse effect

A

yes; Bronchospasm

25
Q

How is esmolol administered? What is recommended for monitoring?

A

bolus followed by infusion; Intra-arterial BP monitoring.

26
Q

The preferred medications for aortic aneurysm or dissection is _________

A

Esmolol.

27
Q

Labetalol is a combined ______and (selective or nonselective) ______adrenergic receptor blocker than reduces ______ while maintaining ______ and does not reduce ____, _____, or ____blood flow

A

Alpha; Beta; afterload, cardiac output; cerebral, coronary and renal

28
Q

What is the preferred therapy in the treatment of renal hypertensive patients is _______ and that is because _____ ____ levels are reduced by the administration of__________

A

Labetalol; elevated renin; labetalol.

29
Q

The use of _______ in the treatment of hypertensive emergencies and urgencies both are safe in pregnancy

A

Labetalol

30
Q

Patients that may have an increase responsiveness of labetalol are patients with _______Impairment

A

Hepatic

31
Q

Abrupt withdrawal of labetalol may cause ________, _______ and ________ Therefore It should gradually ______especially in patients with ________

A

Tachycardia, rebound hypertension, ischemia; Tapered; CAD

32
Q

Fenoldopam is a (class)___________

A

Peripheral vasodilator

33
Q

Action of fenoldopam is that it is mediated by peripheral ____________-1 receptors with high selectivity for _______ and ______tubules of the kidney causing renal artery ________, inhibition of ______reabsorpition , ________ and ________

A

dopamine; distal and proximal; vasodilation; sodium; natriuresis; diuresis.

34
Q

Fenoldopam is contraindicated in _______ and has not yet been studied with patients with increased

A

Glaucoma; ICP

35
Q

Fenoldopam is a preferred agent in patients with _____impairment

A

Renal

36
Q

An arterial and venous vasodilators is

A

Sodium nitroprusside.

37
Q

Sodium Nitroprusside is contraindicated in _______ and _____ and use cautiously with patients with MI because of the potential for ________ ____ _____

A

aortic stenosis; coarctation ; coronary steal syndrome.

38
Q

Prolonged administration of nitroprusside , especially with patient with renal impairment can lead to an increased risk of developing fatal _______ or _____toxicity

A

cyanide; thiocyanate

39
Q

Monitoring for sodium nitroprusside include monitoring for _________ and _______Because it can lead to local _____ _______

A 
Metabolic acidosis (cyanide toxicity)
and venous oxygen concentration and signs of extravasation ; tissue necrosis.
40
Q

Nitroglycerin causes pronounced ________ _____ and results in decreased _____, _____, and oxygen demands while increasing ______ ______ and suppressing coronary _________

A

venous dilation; preload, cardiac output; coronary blood flow; vasospasms

41
Q

Tolerance with a patient getting nitroglycerin will occur within _________

A

24-48 hours

42
Q

Hydralazine is a direct _______ ______that reduces ______

A

arterial vasodilator; afterload

43
Q

Hydralazine is preferred for use in the treatment of _____ or ________

A

preeclampsia or eclampsia.

44
Q

The newest antihypertensive agent available in the US is _____________

A

Clevidipine

45
Q

The action of clevidipine is that it is a 3rd generation dihydropiridine________ that causes _________vaso_______, decreases (afterload or preload) increases ______ _______ and ______ without affecting cardiac _____ _____ or ____

A

CCB; arteriole; dilation; afterload; cardiac output and stroke volume ;filling pressure or HR

46
Q

Nicardipine is a second generation __________ _______ that is selective for arterial _________ _____ muscle with strong _______ and ______vasodilatory activity

A

diphydropiridine CCB ; smooth; cerebral and coronary

47
Q

Recommended for patients with SBP more than 230 mmHg and DBP of .121mmHG is __________

A

Nicardipine

48
Q

In general, in hypertensive emergencies , ________ are preferred over ___________-

A

continuous infusion; boluses

49
Q

Those medications can cause further volume contraction and usually worsen hypertension that is caused by increased renin production and should be avoided unless specifically indicated for fluid overload.

A

Loop diuretics

50
Q

After obtaining the initial goal reduction in BP levels, pt should be transitioned to ___________

A

oral therapy

N5160 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions