Vital Signs_Blood Pressure

Question 1

systolic blood pressure

Answer 1

Question 2

What effect BPsys

Answer 2

Question 3

How would Systolic hypertension of the elderly present

Answer 3

Question 4

What is diastole BP

Answer 4

Question 5

What effects BPdia

Answer 5

Question 6

Mean arterial pressure

Answer 6

Question 7

Blood pressure does not remain constant throughout the day.

Answer 7

Question 8

Diastolic BP Variation during exercise

Answer 8

Question 9

Systolic BP changes during exercise

Normal and Abnormal

Answer 9

Question 10

Que es Pulse Pressure

Answer 10

Question 11

Que es Wide Pulse Pressure

Answer 11

is greater than 60 mm Hg or greater than 50% of BPsys.

Question 12

What diseases/ diagnosis? can patients with Wide Pulse Pressures have?

Answer 12

• Essential hypertension
• High cardiac output
• Chronic aortic regurgitation

Question 13

Essential hypertension

Answer 13

Essential hypertension is the most common cause for a wide pulse pressure.

• Can usually assume genetic and environmental factors appear to be important in the genesis of essential hypertension.
• Essential hypertension almost always begins between the ages of 35 and 55
• Patients with long standing essential hypertension should be assessed for the signs of end-organ damage.

Question 14

High cardiac output

Answer 14

states such as anemia, hyperthyroidism, pregnancy and fever

Question 15

Chronic aortic regurgitation

Answer 15

Question 16

Narrow Pulse Pressure

Answer 16

Question 17

What diseases/probles does Narrow Pulse Pressure cue to??

Answer 17

• Aortic Stenosis
• left ventricular systolic dysfunction (CHF) clinical congestive heart failure

Question 18

Aortic Stenosis

Answer 18

Question 19

left ventricular systolic dysfunction (CHF)

Answer 19

Question 20

Hypertension

• Normal
• Elevated
• Stage 1 Hypertension
• Stage 2 Hypertension

Answer 20

*

Question 21

The diagnosis of hypertension can be made in the following situations:

Answer 21

a. A BP over 160/100 with evidence of target end organ damage.
b. A BP over 130/80 verified by:
* Automated ambulatory BP monitoring is the current gold

standard for the diagnosis of hypertension.

• Home blood pressure monitoring twice a day for seven days

with an average BP over 130/80.

• BP measured on at least two separate office visits over the

course of a week.

• Blood Pressure should be recorded for each arm; the arm

with the higher number should be used for subsequent

measurements.

Question 22

Automated ambulatory BP technique

Answer 22

Question 23

Home blood pressure monitoring technique

Answer 23

Question 24

BP measured on office visits technique

Answer 24

Question 25

secondary causes for hypertension (When hypertension begins outside of age range,)

Answer 25

Organ Damage causes for hypertension (adrenal tumors and vascular occlusion) must be considered.

Question 26

Patients with long standing essential hypertension should be assessed for the signs of end-organ damage.

Answer 26

Question 27

Hypotension - Como se dice

Answer 27

* systolic blood pressure is less than 90 mm Hg and/or * diastolic blood pressure is less than 60 mm Hg.

Question 28

Que es el causes of Hypotension

Answer 28

* Reduced cardiac function (**myocardial infarction** or **valvular** **disease**) * Obstruction to ventricular filling (**tamponade or pulmonary emboli**) * Decreased intravascular volume (**blood loss or fluid loss**) * Excessive vasodilation (**microbial sepsis or drugs**)

Question 29

Reduced cardiac function

Answer 29

* myocardial infarction * valvular disease

Question 30

Obstruction to ventricular filling

Answer 30

* tamponade * pulmonary emboli *

Question 31

Decreased intravascular volume

Answer 31

* blood loss * fluid loss * vomitting * diareha * low blood pressure when they sit up

Question 32

Orthostatic hypotension (postural hypotension)

Answer 32

* decrease in systolic blood pressure by 20 mm Hg or more with standing * orthostatic hypotension occurs in 10% of normal people **younger** than age **65** and in as many as 30% of people **older** than **65.** * Blood pressure should not be measured until the patient has been standing for one minute after arising from a supine position.

Question 33

How to diagnose Orthostatic hypotension (postural hypotension)

Answer 33

* best determined by noting the effect that the drop in blood pressure has on the patient and the patient’s pulse rate. * When the patient is unable to stand because of the drop in pressure or * when the drop in pressure is accompanied by an increase in pulse rate of 30 beats per minute or more, **there is a high likelihood that there has been a large decrease in intravascular volume.** or * When the drop in pressure is unaccompanied by an inability to stand or a 30 beats/min increase in pulse rate, postural hypotension has little diagnostic value * In this regard, postural hypotension may represent failure of the sympathetic nervous system (diabetic autonomic neuropathy) to respond to the 500 mls of blood that normally shift to the lower body with standing; or may reflect nothing more than a common occurrence inotherwise healthy people.

Question 34

why does systolic bp fall and dia BP rise when standin up after being supine

Answer 34

blood rushes to pool in the lower extermities miking the stroke volume decrease because the venous returns drops because the blood has gravity working to make it pool. The sympathetic nervous system get invovled and increasest the HR (CO=HR\*SV) to compinsate for the dreace in stroke volume and the SNS also affects vasocontriction to increase which in turn causes increase resistance which increase BPdia.

Question 35

Systolic blood pressure during inspiration

Answer 35

Systolic blood pressure may decrease by as much as 12 mm Hg during inspiration. The average decrease for normal adults is 6 mm Hg (±3). The inspiratory drop in blood pressure also relates to changes in pressure across the myocardial wall that occur in response to cyclic alterations of the intra-thoracic pressure during breathing.

Question 36

This inspiratory drop in blood pressure may result from pooling of blood in the right atrium, right ventricle, and pulmonary circulation, thereby decreasing the amount of blood available to the left ventricle for ejection.

Answer 36

Question 37

The inspiratory drop in blood pressure also relates to changes in pressure across the myocardial wall that occur in response to cyclic alterations of the intra-thoracic pressure during breathing.

Answer 37

Question 38

paradoxical pulse

Answer 38

* **pericardial tamponade** * **bronchospasm (asthma).** A paradoxical pulse is an abnormal finding that exists when there is an inspiratory decrease in systolic blood pressure by more than 12 mm Hg (the upper 95% confidence interval for inspiratory decline in normal people). Paradoxical pulse occurs in 98% of patients with pericardial tamponade and in more than 50% of patients with severe bronchospasm (asthma).

Question 39

pericardial tamponade

Answer 39

Question 40

asthma

Answer 40

Question 41

Bifid

Answer 41

HOCM