Hypertension (201)

Question Answer
What is HTN Systolic greater then 140, diastolic greater then 90
What is prehypertension 120-139 over 80-89
What is primary HTN Results from undentified cause
Secondary HTN A cause for the BP can be identified
Hypertension can be classified as….. (3) A sign
A risk factor
A disease
Prolonged hypertension damages (4) Heart, kidneys, brain, eyes
Cardiac output Total volume of blood pumped by the heart each minute
Peripheral resistance Construction of blood vessels
Heart rate Beats per minute
Stroke volume Volume of blood pumped by the left ventricle per beat
Cardiac output= Heart rate x Stroke volume
Blood Pressure= CO x Peripheral resistance
What does a beta blocker block? Blocks Norepinepherine from attaching to the beta 1 receptor
What is the body's response to beta blocker medications Decreased heart rate
Decreased force of contraction
Decreased speed of conduction= decreased BP
What process do ace inhibitors and angiotensin II receptor blockers interrupt Renin- Angiotension-aldosterone system
Ace inhibitors and angiotensin II receptor blockers do what to the body Vasodialate
Decrease extra cellular fluid
Assessment and diagnostics for HTN management (8) Health Hx/physical exam
Serum electrolytes
Urinalysis
BUN and Creatinine
12 lead EKG
Echocardiogram
Retinal exam
Goal for medical management of HTN Achieve and maintain a BO at 140/90 or lower
Pharmacological TX for HTN (7) Diuretics
Central Alpha 2 agonists
Beta blockers
Vasodilators
ACE inhibitors
Angiotensin II receptor blockers
Calcium Chanel blockers
Action diuretic have on reducing BP Decreased blood volume
Action central alpha 2-agonists have on reducing BP Helps norepinephrine bind to alpha II, which stops release of more norepinephrine
Action beta blockers have on reducing BP Blocks beta I receptors, lowers HR, force of contraction, speed of conduction
Action vasodilators have on lowering BP Dilates blood vessels
Action ACE inhibitors have on lowering BP Stops angiotensin II from forming, decreases blood volume, decreases CO
Action angiotensin II receptor blockers have on lowering BP Stops angiotensin II from binding. Decreased blood volume, decreased CO
Action calcium channel blockers have on lowering bp Acts on heart muscle to decrease heart rate and force of contraction
What is isolated systolic hypertension Aorta is unable to accommodate for stroke volume and vessels are unable to stretch… result= systolic increases but no change in diastolic
Hypertensive emergency BP extremely elevated organ damage will or is occuring
Hypertensive urgency Blood pressures very elevated, no evidence of impending or progressing organ damage
Therapeutic goals for hypertensive emergency Reduce MAP 20-25% in first hour
BP 160/100 in 6 hours
Gradual reduction in BP over a few days
Conditions associated with Hypertensive emergency (4) Myocardial infarction
Hypertension of pregnancy
Dissecting aortic aneurysm
Intracranial hemorrhage
Nursing care for hypertensive urgency Oral agents to reduce BP in 1-2 days
Close hemodynamics monitoring