NUR 114 - Hypertension EXAM III Flashcards
a measure of the force exerted by the blood against the walls of the blood vessels
blood pressure
Arterial baroreceptor system
Regulation of body fluid
RAAS
Vascular autoregulation
responsible for maintenance of blood pressure
Hormone system in the body that regulates blood pressure and fluid balance
Renin - Angiotensin System
When BP in the kidneys fall, a compensatory mechanism occurs to assure that blood flow is maintained. A low BP causes the release of renin into the bloodstream from a group of cells in the glomeruli of the kidneys. When renin arrives in the liver, it converts angiotensinogen to angiotensin 1
How the Renin - angiotensin system works
________ goes to the lungs where the alveoli convert it to Angiotensin 2
Angiotensin 1
_________ acts to raise peripheral resistance; thus, raising the blood pressure, restoring blood flow to the kidneys and decreasing the release of renin
Angiontensin 2
_________ converts to angiotensin 3 stimulating the adrenal cortex to release aldosterone to increase BP and fluid volume, and the problem is resolved
Angiotensin 2
anxiety, fear, and pain can cause an ________ in blood pressure.
increase
Normal - <120 over <80
BP 120 – 129/<80 (Prehypertension)
BP 130 – 139/80 – 89 (Hypertension stage I)
BP 140 or higher /90 or higher (hypertension stage II)
BP > or = 180/120 (Hypertensive crisis)
Stages of Hypertension
Adult over sixty years, start medication if BP is greater than ________.
150/90
Adult under sixty years, start medication if BP is greater than _______.
140/90
Most common type of hypertension, usually of unknown origin occurring in 90-95% of all patients diagnosed with hypertension.
essential hypertension
what can hypertension lead to ?
MI, CVA, peripheral vascular disease
Age >60 or postmenopausal Ethnicity Alcohol Diabetes Mellitus Elevated serum lipids Sodium and caffeine Socioeconomic status Electrolyte imbalance
risk factors for essential hypertension
_______ ___________ is related to renal, endocrine, cardiovascular, neurological disorders, pregnancy and certain drugs such as estrogen and cocaine. type of hypertension that is a result of a different medical issue..
*treatment consists of eliminating the cause.
secondary hypertension
this type of hypertension is a major threat for older adults. Increases the risk for CVA, heart disease, and PVD.
- systolic BP > 139
- diastolic BP < 90
isolated systolic hypertension
Vague symptoms such as: Fatigue Dizziness Blurred vision Palpitations Angina Dyspnea Facial flushing
clinical manifestations for hypertension
Sodium restriction (less than 2 g) Weight reduction Reduce alcohol intake (women 1 men 2) Exercise (40 mins, 3-4x a week) Decrease stress levels Avoid smoking Complementary and alternative therapy
Lifestyle changes recommended for those with hypertension
clinical manifestation:
BP >180/120 mm Hg
No signs of target organ damage
Usually caused by non-compliance with medication therapy
hypertension urgency
clinical manifestations:
BP >180/120 mm Hg
*Signs of target organ damage
hypertension emergency
clinical manifestations: Severe elevated BP S/S Morning headaches Blurred vision Dyspnea Uremia Systolic pressure greater than 200 Diastolic pressure greater than 150 High risk for kidney failure, left ventricular failure, brain attack or death
malignant hypertension
- monitor patient q 5 minutes
- given nitroproxide in emergency situations this drug must be given in a drip.
Occurs most often when patients are noncompliant with medication therapy or have drug resistant hypertension Rapid onset BP: 180/120 (Hypertensive urgency) BP: 220/140 (Hypertensive emergency) SEVERE headache Dizziness Blurred vision Epistaxis Severe anxiety unresponsiveness observe for seizures shortness of breath chest pain (angina) decreased output (less than 30 ml/hr) anxiety
hypertensive crisis
Nurses Place patient in semi-fowlers Give O2 Start IV with normal saline Nitroprusside (Nitropress) (must be given in a drip) labetalol (Normodyne) Nicardipine (Cardene) Monitor BP q 15 min Observe for s/s seizures, organ damage
nursing interventions for hypertensive crisis
what three ethnic groups are at a higher risk for hypertension?
African Americans, Asian, and Native Americans
Hypertension is often called the ______ _______because it is asymptomatic until severe enough to cause target organ damage to:
Heart (hypertensive heart disease)
Brain (cerebrovascular disease)
Peripheral vasculature (peripheral vascular disease)
Kidney (nephrosclerosis and renal insufficiency)
Eye (papilledema)
silent killer
steps when dealing with someone in pain, having anxiety and dealing with hypertenison
M - morphine
O - oxygen
N - nitrate
A - aspirin
1) lifestyle management
2) diuretic …..and then….
3) other medical management
course of treatment for hypertension
what does protein in the urine indicate?
means that the kidneys aren’t functioning correctly
