Exam 2 - HTN

Question 1

main risk factor for CAD

Answer 1

HTN

Question 2

most common chronic disease among US adults

Answer 2

HTN

Question 3

how is it determined an individual has HTN

Answer 3

SBP > 140 or DBP >90 based on an average of 2 or more accurate BP measurements taken 1-4 weeks apart

Question 4

HTN is aka

Answer 4

the silent killer

Question 5

which race has the highest prevalence of HTN

Answer 5

African Americans

Question 6

cause of primary HTN

Answer 6

idiopathic

95% of pts

Question 7

cause of secondary HTN

Answer 7

renal disease
sleep apnea
pregnancy related

–secondary d/t an another underlying issue

Question 8

symptoms r/t organ damange

Answer 8

retinal, other eyes changes
renal damage
MI
cardiac hypertrophy
stroke, TIA

Question 9

HTN risk factors

Answer 9

alcohol
gender
smoking
obesity
physical inactivity
dyslipidemia
DM
CKD/impaired renal function
older age
family hx

Question 10

how many alcoholic drinks are okay daily for men and for women?

Answer 10

m: 2
w: 1

Question 11

medical management BP range for an individual with HTN

Answer 11

< 130/80

Question 12

lifestyle modification for HTN

Answer 12

weight loss
DASH diet, decrease Na intake
regular physical activity
reduce alcohol comsumption

Question 13

stage 1 HTN drug classes of choice for African Americans and pts > 60 y/o

Answer 13

CCB

thiazide diuretics

Question 14

stage 1 HTN drug classes of choice for non-African Americans and pts < 60 y/o

Answer 14

ACE-I

ARB

Question 15

will pts be started on a low or high dose of BP med initially?

Answer 15

low, increase gradually if needed

Question 16

when is it considered resistant HTN?

Answer 16

UNCONTROLLED with 3 different types of BP meds (including diuretics)

*controlled with 4

Question 17

potential complications of HTN

Answer 17

L ventricular hypertrophy
MI
HF
TIA
CVA, stroke, brain attack
renal insufficiency/CKD
retinal hemorrhage

Question 18

gerontologic considerations

Answer 18

med regimen can be difficult to remember
expenses
comprehension
include family, caregivers
monotherapy

Question 19

when BP increases so the risk for…

Answer 19

MI
HF
stroke
renal disease

Question 20

HTN is a ___ ___ ___ ___ identified in Healthy People 2020.

Answer 20

high priority health concern

Question 21

83% of people over the age of ___ are aware they have high BP

Answer 21

20

Question 22

HTN crisis is divided into which 2 categories?

Answer 22

urgency

emergency

Question 23

BP reading for HTN urgency

Answer 23

> 180/110

Question 24

is HTN urgency quick acting?

Answer 24

develops over hours to days

Question 25

meds to tx HTN urgency

Answer 25

catapres capoten normodyne

Question 26

HTN emergency BP reading

Answer 26

> 220/140

Question 27

is there target organ damage with urgency or emergency?

Answer 27

emergency

Question 28

what are some causes of HTN emergency?

Answer 28

noncompliance with meds | under-medicated

Question 29

what are some problems that can occur during a HTN crisis?

Answer 29

``` encephalopathy intracranial, subarachnoid hemorrhage HF MI renal damage dissection aortic aneurysm retinopathy ```

Question 30

s/sx of HTN emergency

Answer 30

HA | N/V

Question 31

syndrome in which a sudden rise in BP is associated with HA, N/V, seizures, confusion, coma are the results of increased cerebral capillary permeability

Answer 31

HTN encephalopathy

Question 32

s/sx of cardiac decompensation

Answer 32

``` unstable angina MI HF pulmonary edema can have chest pain, dyspnea ```

Question 33

s/sx of aortic dissection

Answer 33

sudden, excruciating chest, back pain | possibly reduced or absent pulses in the extremities

Question 34

how much do you want to try to reduce the SBP during a HTN crisis within the first hour?

Answer 34

< 25% *MAP 20-25% or 110-115mmHg

Question 35

how much do you want to try to reduce the SBP during a HTN crisis within hours 2-6?

Answer 35

160/110

Question 36

when should BP be controlled after initiating tx'ment for HTN crisis

Answer 36

24-48 hours

Question 37

IV anti-HTN drugs titrated to MAP or BP

Answer 37

``` Vasodilators -nicardipine (CCB); sodium nitroprusside Adrenergic Inhibitors -Phentolmine; labetalol (A+B blocker) ACE-I -Enalapril ```