Unit 10 - Hypertension

Question 1

Hypertension is systolic BP _____ mmHg or higher

Answer 1

140

Question 2

hypertension is diastolic BP _____ mmHg or higher

Answer 2

90

Question 3

approximately _____ of adults with hypertension are unaware of the condition

Answer 3

30%

Question 4

approximately _____ of adults being treated for hypertension achieve control

Answer 4

34%

Question 5

force exerted against the walls of the arteries by the blood as it is pumped from the heart

Answer 5

blood pressure

Question 6

highest pressure exerted against the arterial walls at the peak of ventricular contraction

Answer 6

systolic

Question 7

lowest pressure exerted during ventricular relaxation

Answer 7

diastolic

Question 8

difference between the systolic and diastolic pressure

Answer 8

pulse pressure

Question 9

3 factors that determine peripheral vascular resistance

Answer 9

• blood viscosity
• length of the vessel
• diameter of the vessel

Question 10

opposing forces or impedance to blood flow

Answer 10

peripheral vascular resistance

Question 11

atrial natriuretic peptide is released by _____ _____ in the _____ chambers (_____) of the heart (_____ _____) in response to high blood volume. ANP acts to reduce water, sodium, and adipose loads on the circulatory system, thereby reducing blood pressure.

Answer 11

muscle cells
upper
atria
atrial myocytes

Question 12

persistently elevated systemic BP

Answer 12

primary hypertension

Question 13

Primary hypertension develops through interaction between:

• overstimulation of _____- and _____- _____ receptors
• altered function of the _____-_____ _____ system
• other chemical mediators of blood _____ and _____ tone
• interaction among insulin resistance, hyperinsulinemia, and endothelial function

Answer 13

• overstimulation of alpha-and beta-adrenergic receptors
• altered function of the renin-angiotensin-aldosterone system
• other chemical mediators of blood volume and vasomotor tone
• interaction among insulin resistance, hyperinsulinemia, and endothelial function

Question 14

emergency hypertension

Answer 14

> 180/>120

Question 15

name for emergency hypertension

Answer 15

malignant hypertension

Question 16

For malignant hypertension, treatment must occur within _____ hour to preserve end-organ function

Answer 16

1

Question 17

hypertensive disorders seen in _____-_____% of pregnancies

Answer 17

2-3%

Question 18

preeclampsia occurs after _____ weeks

Answer 18

20

Question 19

early signs of preeclampsia

Answer 19

• hypertension

- protein in urine

Question 20

preeclampsia women who develop are at risk for developing chronic _____ later in life

Answer 20

hypertension

Question 21

as preeclampsia progresses, more severe symptoms become evident; potentially _____

Answer 21

fatal

Question 22

HELLP

Answer 22

H - hemolysis
EL - elevated liver enzymes
LP - low platelet count

Question 23

cure for preeclampsia

Answer 23

deliver the baby

Question 24

hypertension primarily affects _____-aged and _____ adults

Answer 24

middle-aged & older adults

Question 25

hypertension is more prevalent in _____ than _____ or _____

Answer 25

blacks than white or hispanics

Question 26

hypertension: | in whites and hispanics, more _____ than _____

Answer 26

males than females

Question 27

hypertension: | in blacks, more _____ than _____

Answer 27

females than males

Question 28

primary hypertension is diagnosed when...

Answer 28

no specific cause in known

Question 29

_____ _____ is the most common identifiable cause of secondary hypertension in adults and children

Answer 29

kidney disease

Question 30

initially, elevated BP is only a _____

Answer 30

symptom

Question 31

Clinical manifestations: Vague symptoms of _____ upon awakening that disappear through the course of the day, nocturia confusion nauseam vomiting, visual, disturbances

Answer 31

headache

Question 32

Clinical manifestations: | _____ changes in the eye

Answer 32

retina

Question 33

Clinical manifestations: | can develop hypertensive _____

Answer 33

encephalopathy

Question 34

Main goals of care: - reduce BP to < _____/_____ - reduce _____ and _____ mortality and morbidity

Answer 34

- < 140/90 | - cardiovascular and renal

Question 35

Lifestyle modifications: - diet - reduce _____ intake - maintain adequate _____ and _____ intake - reduce _____ and _____ fat - weight ____ - loss of _____ pounds reduces BP in many people

Answer 35

- diet - reduce sodium intake - maintain adequate potassium and calcium intake - reduce total and saturated fat - weight loss - loss of 10 pounds reduces BP in many people

Question 36

_____ exercise can raise systolic BP

Answer 36

isometric

Question 37

recommended alcohol intake is no more than _____ _____ of ethanol or _____ drinks/day a drink is _____ ounces of beer, _____ ounces of wine or _____ ounces of 80-proof whiskey women should reduce this alcohol intake by _____

Answer 37

1 oz or 2 drinks 12 5 1.5 half

Question 38

stress stimulates the _____ _____ _____

Answer 38

Systemic nervous system (SNS)

Question 39

Pharmacologic therapy: | particularly for clients who are older, African American,, obese, or have increased plasma volume or low renin activity

Answer 39

diuretics

Question 40

Pharmacologic therapy: | for clients with diabetes or heart failure, history of MI, or chronic kidney diseases

Answer 40

ACE inhibitors

Question 41

Pharmacologic therapy: | for clients with diabetes or heart failure, history of MI or chronic kidney diseases

Answer 41

angiotensin II receptor blockers

Question 42

Pharmacologic therapy: | can cause orthostatic hypotension

Answer 42

alpha-adrenergic blockers

Question 43

Pharmacologic therapy: | for clients with heart failure, coronary heart diseases, or diabetes

Answer 43

beta-adrenergic blockers

Question 44

Pharmacologic therapy: | can cause reflect tachycardia, some suppress heart function

Answer 44

calcium-channel blockers

Question 45

Drug regimens: | if drug tolerated well but BP not controlled...

Answer 45

a second drug is added

Question 46

after a year of successful therapy, effort may be made to reduce the number of drugs and dose; this is "_____ _____" therapy

Answer 46

step down