Unit 10 - Hypertension Flashcards
Hypertension is systolic BP _____ mmHg or higher
140
hypertension is diastolic BP _____ mmHg or higher
90
approximately _____ of adults with hypertension are unaware of the condition
30%
approximately _____ of adults being treated for hypertension achieve control
34%
force exerted against the walls of the arteries by the blood as it is pumped from the heart
blood pressure
highest pressure exerted against the arterial walls at the peak of ventricular contraction
systolic
lowest pressure exerted during ventricular relaxation
diastolic
difference between the systolic and diastolic pressure
pulse pressure
3 factors that determine peripheral vascular resistance
- blood viscosity
- length of the vessel
- diameter of the vessel
opposing forces or impedance to blood flow
peripheral vascular resistance
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.
muscle cells
upper
atria
atrial myocytes
persistently elevated systemic BP
primary hypertension
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
- 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
emergency hypertension
> 180/>120
name for emergency hypertension
malignant hypertension
For malignant hypertension, treatment must occur within _____ hour to preserve end-organ function
1
hypertensive disorders seen in _____-_____% of pregnancies
2-3%
preeclampsia occurs after _____ weeks
20
early signs of preeclampsia
- hypertension
- protein in urine
preeclampsia women who develop are at risk for developing chronic _____ later in life
hypertension
as preeclampsia progresses, more severe symptoms become evident; potentially _____
fatal
HELLP
H - hemolysis
EL - elevated liver enzymes
LP - low platelet count
cure for preeclampsia
deliver the baby
hypertension primarily affects _____-aged and _____ adults
middle-aged & older adults
hypertension is more prevalent in _____ than _____ or _____
blacks than white or hispanics
hypertension:
in whites and hispanics, more _____ than _____
males than females
hypertension:
in blacks, more _____ than _____
females than males
primary hypertension is diagnosed when…
no specific cause in known
_____ _____ is the most common identifiable cause of secondary hypertension in adults and children
kidney disease
initially, elevated BP is only a _____
symptom
Clinical manifestations:
Vague symptoms of _____ upon awakening that disappear through the course of the day, nocturia confusion nauseam vomiting, visual, disturbances
headache
Clinical manifestations:
_____ changes in the eye
retina
Clinical manifestations:
can develop hypertensive _____
encephalopathy
Main goals of care:
- reduce BP to < _____/_____
- reduce _____ and _____ mortality and morbidity
- < 140/90
- cardiovascular and renal
Lifestyle modifications:
- diet
- reduce _____ intake
- maintain adequate _____ and _____ intake
- reduce _____ and _____ fat
- weight ____
- loss of _____ pounds reduces BP in many people
- 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
_____ exercise can raise systolic BP
isometric
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 _____
1 oz or 2 drinks
12
5
1.5
half
stress stimulates the _____ _____ _____
Systemic nervous system (SNS)
Pharmacologic therapy:
particularly for clients who are older, African American,, obese, or have increased plasma volume or low renin activity
diuretics
Pharmacologic therapy:
for clients with diabetes or heart failure, history of MI, or chronic kidney diseases
ACE inhibitors
Pharmacologic therapy:
for clients with diabetes or heart failure, history of MI or chronic kidney diseases
angiotensin II receptor blockers
Pharmacologic therapy:
can cause orthostatic hypotension
alpha-adrenergic blockers
Pharmacologic therapy:
for clients with heart failure, coronary heart diseases, or diabetes
beta-adrenergic blockers
Pharmacologic therapy:
can cause reflect tachycardia, some suppress heart function
calcium-channel blockers
Drug regimens:
if drug tolerated well but BP not controlled…
a second drug is added
after a year of successful therapy, effort may be made to reduce the number of drugs and dose; this is “_____ _____” therapy
step down
