UNIT 6 HYPERTENSION CHAPTER 33

Question 1

What is Hypertension?

Answer 1

Hypertension, or high blood pressure (BP), is the most common health problem seen in primary care se ings and can cause stroke, myocardial infarction (MI) (heart a ack), kidney failure, and death if not treated early and effectively.

Question 2

What are Risk Factor of Hypertension?

Answer 2

*Essential (primary)
* Common risk factors
* Obesity
* Smoking
* African-American ethnicity
Excessive and continuous stress
* Family history
* Hyperlipidemia
* Physical inactivity

*Secondary- Secondary has a known cause which is usually a medical
condition or disease.
* Common causes:
* Kidney disease
* Pregnancy
* Primary aldosteronism
* Cushing’s syndrome
* Medications

Question 3

Signs/ Symptoms of Hypertension

Answer 3

Clinical manifestations
* Asymptomatic presentation; although, some clients may endorse headaches,
facial flushing, and/or dizziness.
* Assess for family history, dietary intake, occupation, BMI, and exercise habits.
* BP readings and diary

Question 4

What is treatment for Hypertension?

Answer 4

to decrease high blood pressure

Start with lifestyle changes such as exercise and diet, and decrease stress

• Can move to medications addressing the issues:
• Vasoconstriction should be treated with vasodilation medications (or at least medications which turn off the body from vasoconstricting)
• Fluid overload issues can be treated with diuretics
• Sometimes the issue is related to both fluid and vascular and will be treated with both types of medications
• Vessels which have plaque

Question 5

Which of the following foods foods should a pt with hypertension avoid to prevent vasoconstriction?

A. ice popsicle
B. warm tea
C. chicken broth
D. black coffee
E. dark chocolate

Answer 5

D. black coffee
E. dark chocolate
A. ice popsicle

Question 6

Diuretics for hypertension

Answer 6

Diuretics
* Thiazide
* Inhibits sodium, chloride, and water reabsorption in the distal tubules while promoting
potassium, bicarbonate and magnesium excretion
* Hydrochlorothiazide (Diuril)

• Loop diuretics
• Inhibit sodium, chloride, and water reabsorption in the ascending loop of Henle and
  promote potassium excretion
• Furosemide (Lasix)
• Potassium-sparing diuretics
• Act on distal renal tubule to inhibit reabsorption of sodium ions in exchange for
  potassium
• Spironolactone (Aldactone)

Question 7

Hypertension Medications – Prevent
Vasoconstriction

Answer 7

Hypertension Medications – Prevent
Vasoconstriction
* Angiotensin-converting enzyme (ACE) inhibitors
* Prevent conversion of angiotensin I to angiotensin II
* Blocks aldosterone
* Enalapril (Vasotec)
* Fosinopril (Monopril)
* Lisinopril (Zestril)

• Angiotensin-receptor blockers (ARBs)
• Blocks the effect of angiotensin II receptors
• Blocks aldosterone
• Valsartan (Diovan)
• Irbesartan (Avapro)
• Losartan (Cozaar)

Question 8

• Calcium channel blockers and Beta Blockers

Answer 8

• Calcium channel blockers
• Interferes with the transmembrane flux of calcium ions
   vasodilation
  decreased BP
• Amlodipine (Norvasc)
• Verapamil (Calan)

Beta Blockers
* Beta-adrenergic blockers
* Block norepinephrine and epinephrine (adrenaline) from binding to beta
receptors on nerves
* Metoprolol (Lopressor)
* Carvedilol (Coreg)
* Cardio-selective vs non-selective

Question 9

What can

Answer 9

Hypertension - Complications
* Hypertensive Crisis – BP 180/120mmHg
* Can damage organs
* Can cause issues such as blurred vision, SOB, Epistaxis, Chest Pain,
severe headache

• Monitor BP, position in semi-Fowler’s, calm environment, needs
  critical care

Question 10

What is the Desired Blood Pressure for people over than 60

Answer 10

• According to JNC 8
• For people over 60:
• Below 150/90
• For people younger than 60:
• Below 140/90
• According to Joint National Committee 8 (JNC
  8) guidelines, patients whose blood pressures
  are above these goals should be treated with
  drug therapy.