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N232 > Module 4 - part 2: HTN > Flashcards

Module 4 - part 2: HTN Flashcards

1
Q

What is HTN?

A

Persistently elevated BP

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2
Q

How do you calculate MAP

I thiiiink she just included this for fun, but ill put it here just in case

A

MAP = (2 X DBP) + SBP / 3

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3
Q

What is a normal MAP?

A

Normal MAP: 70-105 mmHg (90-100 ideal)

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4
Q

How do you calculate pulse pressure (PP)?

A

PP = SBP – DBP

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5
Q

What is a normal PP?

A

Normal PP: 30-40 mmHg

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6
Q

What is high normal HTN?

A

High normal = 130-139 and/or 85-89

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7
Q

What is grade 1 HTN?

A

Grade 1 = 140-159 and/or 90-99

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8
Q

What is grade 2 HTN?

A

Grade 2 = 160-179 and/or 100-109

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9
Q

What is grade 3 HTN?

A

Grade 3 = >180 and/or >110

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10
Q

What is PRIMARY HTN?

A
  • Most common
  • Idiopathic
  • Multifactorial
  • D/t at least 1 of the 4 major BP controls not working
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11
Q

What are the major BP controls

A

1) Baroreceptors
2) RAAS
3) Volume regulation
4) Vascular autoregulation

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12
Q

What is SYSTOLIC HTN?

A

When pressure is elevated during the pumping phase of the heart S = above 140, but D is normal still

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13
Q

What is SECONDARY HTN?

A
  • 5-10% of HTN cases
  • Etiology is known (generally d/t renal problems eg
    RAAS)
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14
Q

What is WHIT COAT HTN?

A

Elevated BP when in a clinical setting, otherwise normal BP

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15
Q

What is PREGNANCY INDUCED (GESTATIONAL) HTN?

A

Elevated BP during pregnancy, will return to normal after in most cases

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16
Q

What is MALIGNANT (PERSISTENT, SEVERE, RESISTANT) HTN?

A
  • D over 120
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17
Q

When diagnosing HTN, the first BP reading says “140/90” what is the next step?

A

Take BP 2 more times, then eliminate the initial one and average the last 2

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18
Q

What are the 3 initial assessment for diagnosing HTN?

A

1) Assess for risk factors
2) Identify trigger for elevated BP
3) Assess for signs of target organ damage

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19
Q

Pt w CRD, diabetes, or macrovasc target organ damage returns one month after their first HTN appointment, what is the result of this visit if their BP is 140/90?

A

They will be diagnosed w HTN

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20
Q

Pt w/out CRD, diabetes, or macrovasc target organ damage returns one month after their first HTN appointment, what is the result of this visit if their BP is 140/90?

A

They will not be diagnosed w HTN

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21
Q

At what point would someone w/out CRD, diabetes, or macrovasc target organ damage be diagnosed w HTN?

A

If, after their initial lifestyle changes, their BP is at 180/110, they will be diagnosed w HTN

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22
Q

Why is HTN referred to as the “silent killer”?

A

Because it is generally asymptomatic (except for elevated BP, which is not detected unless pt happens to check their BP regularly) until disease has progressed

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23
Q

What are a few mnfts of BP, aside from elevated BP

know at least 4

A
  • Breathlessness
  • Headache
  • Bleeding from nose
  • Blurred vision
  • Fatigue and sleepiness
  • Tinnitus or ringing in the ears
  • Profuse sweating
24
Q

What are a few major complications of uncontrolled HTN?

A
  • Target organ damage
  • Inc workload for the heart (may lead to hypertrophy)
  • Stress on BVs
  • May cause kidney problems (hypertensive
    nephropathy)
25
Q

Modifiable risk factors for HTN?

know at least 4

A
  • Stress
  • Abdominal Obesity
  • Smoking
  • Dyslipidemia
  • Dysglycemia
  • Sedentary lifestyle
  • Poor dietary habits
26
Q

Non-mod risk factors?

A
  • Family Hx
  • Age: >55
  • Gender: men over women until age 55; over 74
    women
  • Ethnicity
27
Q

Diagnostic tests for HTN?

A
  • Blood biochemistry (Na+, K+, CR, GFR)
  • Fasting glucose
  • Fasting lipid levels (including total, hdl, ldl, and
    triglycerides)
  • Urinalysis
  • ECG
  • Echo
  • Angiogram
28
Q

Important lifestyle mods for HTN

A
  • Smoking Cessation
  • Decrease alcohol consumption 1-2 standard drinks/day
  • DASH
  • Exercise
  • Blood glucose control for people with Diabetes
  • Patient Education
  • Limit use of NSAID’s and Acetaminophen
29
Q

1st pharma intervention for HTN?

A

Diuretics

30
Q

If diuretics are not enough to control HTN, what drugs would be added?

A
  • ACE Inhibitors
  • Ca channel blockers = VASODIL and dec HR
  • Angiotensin 2 receptor blockers = VASODIL
  • Beta blocker
31
Q

How do diuretics lower BP?

A

They inhibit the reabsorption of Na and other fluids (fluids vary depending on the diuretic prescribed, but always Na), these are then excreted in the urine, which decreases vasc vol and BP

32
Q

What should you be assessing/monitoring during diuretic therapy?

A
  • BP
  • Daily weights
  • Intake and output
  • ‘Lytes
  • Renal Fx
33
Q

What are some side effects of diuretics?

A

electrolyte imbalances, hypotension, dehydration

34
Q

How do ACEIs work?

A

They inhibit the conversion of Angiotensin 1 to Angiotensin 2, therefore preventing vascon and promoting vasodil

35
Q

Can ACEIs be used to treat heart failure and MI?

A

Yes

36
Q

What should you be assessing/monitoring when your pt is on an ACEI

A
  • BP
  • HR
  • Assess for signs of edema
37
Q

Side effects of ACEIs include:

A

Hypotension, increased K, cough

38
Q

How do Angiotensin 2 receptor blockers work?

A

The name says it all ;)

this inhibs vasocon and promotes vasodil

39
Q

What should you be assessing/monitoring when your pt is on an Angioten 2 blocker?

A
  • BP
  • HR
  • Assess for signs of edema
40
Q

What are side effects of Angioten 2 blockers?

A

Hypotension, increased K, dry cough

41
Q

Can Angioten 2 blockers be used to manage HF?

A

Yes

42
Q

What do Ca channel blockers do?

A

They block Ca receptors, which dec muscle contraction because Ca is needed for this.

43
Q

T or F:

Ca channel blockers can also be used to treat angina and dysrhythmias

A

T

44
Q

What should you assess/monitor when giving a Ca channel?

A
  • BP
  • HR
  • Intake/output
  • Daily wts
45
Q

What do vasodilators do?

A

They relax the smooth muscle in arteries, causing vasodilation and easier blood flow through vessels

46
Q

What should you assess/monitor when your pt is on vasodilators?

A
  • BP

- I’m honestly not sure what else

47
Q

Side effects of vasodilators?

A
  • Hypotension

- Reflex tachycardia

48
Q

T or F:

Vasodilators are used to treat HTN longterm

A

F, they are used to treat hypertensive crisis in an emergency situation

49
Q

How do beta-blockers work?

A

These are negative inotropes, meaning that they dec the contractility of the heart and lower HR. Specifically, they block the beta1 adrenergic receptors in the heart.

50
Q

What are 5 possible uses for beta-blockers?

A
  • HTN
  • Angina
  • HF
  • MI
  • Migraines
51
Q

What should you be monitoring/assessing if your pt is on a beta-blocker?

A
  • BP

- HR

52
Q

What are 2 side effects of beta-blockers?

A
  • Hypotension

- Bradycardia

53
Q

What is the third step in the three step approach to controlling HTN?

A

Combination drug therapy

54
Q

What is a HTN emergency?

A

A extreme increase in BP, such as a S of 180 or higher, or a D of 129 or higher, a HTN emergency results in organ damage

55
Q

What is HTN urgency?

A

Very similar to a HTN emergency except for one important difference; there is no evidence of organ damage accompanying the elevated BP

56
Q

What are some non-pharma interventions?

know at least 4

A
  • Monitor BP, HR, RR, O2sat
  • Elevate HOB
  • Compression stockings, Elevate legs
  • Monitor Electrolytes
  • Monitor Fluid balance
  • Weigh patient
  • Cardiac Diet, have dietitian see pt

N232 (9 decks)

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