NUR 114 - Hypertension EXAM III

Question 1

a measure of the force exerted by the blood against the walls of the blood vessels

Answer 1

blood pressure

Question 2

Arterial baroreceptor system
Regulation of body fluid
RAAS
Vascular autoregulation

Answer 2

responsible for maintenance of blood pressure

Question 3

Hormone system in the body that regulates blood pressure and fluid balance

Answer 3

Renin - Angiotensin System

Question 4

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

Answer 4

How the Renin - angiotensin system works

Question 5

________ goes to the lungs where the alveoli convert it to Angiotensin 2

Answer 5

Angiotensin 1

Question 6

_________ acts to raise peripheral resistance; thus, raising the blood pressure, restoring blood flow to the kidneys and decreasing the release of renin

Answer 6

Angiontensin 2

Question 7

_________ converts to angiotensin 3 stimulating the adrenal cortex to release aldosterone to increase BP and fluid volume, and the problem is resolved

Answer 7

Angiotensin 2

Question 8

anxiety, fear, and pain can cause an ________ in blood pressure.

Answer 8

increase

Question 9

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)

Answer 9

Stages of Hypertension

Question 10

Adult over sixty years, start medication if BP is greater than ________.

Answer 10

150/90

Question 11

Adult under sixty years, start medication if BP is greater than _______.

Answer 11

140/90

Question 12

Most common type of hypertension, usually of unknown origin occurring in 90-95% of all patients diagnosed with hypertension.

Answer 12

essential hypertension

Question 13

what can hypertension lead to ?

Answer 13

MI, CVA, peripheral vascular disease

Question 14

Age >60 or postmenopausal
Ethnicity
Alcohol
Diabetes Mellitus 
Elevated serum lipids
Sodium and caffeine
Socioeconomic status
Electrolyte imbalance

Answer 14

risk factors for essential hypertension

Question 15

_______ ___________ 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.

Answer 15

secondary hypertension

Question 16

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

Answer 16

isolated systolic hypertension

Question 17

Vague symptoms such as: 
Fatigue
Dizziness
Blurred vision
Palpitations
Angina
Dyspnea
Facial flushing

Answer 17

clinical manifestations for hypertension

Question 18

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

Answer 18

Lifestyle changes recommended for those with hypertension

Question 19

clinical manifestation:
BP >180/120 mm Hg
No signs of target organ damage
Usually caused by non-compliance with medication therapy

Answer 19

hypertension urgency

Question 20

clinical manifestations:
BP >180/120 mm Hg
*Signs of target organ damage

Answer 20

hypertension emergency

Question 21

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

Answer 21

malignant hypertension

• monitor patient q 5 minutes
• given nitroproxide in emergency situations this drug must be given in a drip.

Question 22

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

Answer 22

hypertensive crisis

Question 23

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

Answer 23

nursing interventions for hypertensive crisis

Question 24

what three ethnic groups are at a higher risk for hypertension?

Answer 24

African Americans, Asian, and Native Americans

Question 25

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)

Answer 25

silent killer

Question 26

steps when dealing with someone in pain, having anxiety and dealing with hypertenison

Answer 26

M - morphine
O - oxygen
N - nitrate
A - aspirin

Question 27

1) lifestyle management
2) diuretic …..and then….
3) other medical management

Answer 27

course of treatment for hypertension

Question 28

what does protein in the urine indicate?

Answer 28

means that the kidneys aren’t functioning correctly