PATHO-- alterations in cardiac function

Question 1

short term regulation of systemic blood pressure

Answer 1

baroreceptors monitor changes, activate SNS
parasympathetic system slows HR

Question 2

long term regulation of systemic BP

Answer 2

regulated by neural, hormonal, renal systems. Increased cardiac output and stroke volume rate. increased serum Na levels, increased ADH secretion, RAAS system, connected to fluid volume

Question 3

hypertension

Answer 3

defined as a sustained BP greater than normal, not a single disease but a syndrome with multiple causes

Question 4

primary hypertension

Answer 4

also known as “essential hypertension”– cause is unknown

Question 5

secondary hypertension

Answer 5

cause is known

Question 6

non modifiable risk factors for hypertension:

Answer 6

family history, age, ethnicity, gender

Question 7

modifiable risk factors for hypertension:

Answer 7

stress, food choices, caffeine intake, alcohol dependance, smoking, elevated total cholesterol, sedentary lifestyle

Question 8

primary (essential) hypertension statistics

Answer 8

idiopathic disorder, most common form of hypertension, rare prior to age 10, major risk factor for CV disease

Question 9

pathogenesis of primary (essential) hypertension

Answer 9

vasoconstriction of narrowed peripheral blood vessels, causes increased peripheral resistance, increased workload, and more pressure for the afterload

Question 10

treatment of primary hypertension

Answer 10

lifestyle modifications: weight loss, exercise, alcohol modification, decreased Na+ intake. Drug treatment: for hypertension effects SV, SVR, and HR

Question 11

outcomes related to primary hypertension

Answer 11

end-organ damage, renal failure, stroke, heart disease, damage to arterial system and acceleration of atherosclerosis lead to CV disease, increased myocardial work leads to heart failure, glomerular damage results in kidney failure, affects microcirculation of eyes, increased pressure in cerebral vasculature can result in hemorrhage.

Question 12

secondary hypertension etiologies

Answer 12

renal artery sclerosis, pregnancy induced hypertension, pheochromocytoma, sleep apnea, hyperaldosteronism, obesity, renal disease, cushing syndrome, contraceptive use, drug induced, hyperthyroid, coarctation of aorta, polycythemia

Question 13

hypertension clinical manifestations

Answer 13

may be asymptomatic, headache is common, dizziness, nausea and vomiting, visual disturbances, renal insuffiency

Question 14

hypertensive emergency

Answer 14

sudden increase in either both systolic and diastolic BP with evidence of end organ damage

Question 15

treatment of hypertensive emergency

Answer 15

rapid but controlled reduction of BP using parenteral anti-hypertensive agents under close monitoring (usually ICU)

Question 16

hypertensive urgency

Answer 16

similar BP elevation without evidence of end organ damage

Question 17

treatment of hypertensive urgency

Answer 17

oral prescriptions to bring BP under control in 24-48 hours

Question 18

low blood pressure (orthostatic) postural hypertension

Answer 18

extreme response to change from supine to upright position; activation of short term control mechanisms is slow or inadequate

Question 19

orthostatic hypotension results in..

Answer 19

dizziness, blurred vision, confusion, possible syncope

Question 20

clinical manifestations of orthostatic hypotension

Answer 20

causes decrease in systolic blood pressure greater than or equal to 20 mmhg or 10 mmhg in 3 minutes, and increase in HR by 20/30 BPM when moving to upright position

Question 21

orthostatic hypotension may be a result of

Answer 21

problem of vasomotor or baroreceptor response, adverse effect of drug therapy, arterial stiffness, volume depletion, secondary disease process, vasovagal reaction, cardiac dysrhythmias

Question 22

treatment of orthostatic hypotension

Answer 22

review medication history, slow positional changes, avoid hot environments, avoid large/carb heavy meals, when experiencing symptoms have patient squat forward or cross legs to reduce effect. Use elastic compression stockings, abdominal binders, elevate HOB