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Med Surge 3rd exam > HTN > Flashcards

Flashcards in HTN Deck (73)
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1

What is the impact of HTN in society:

Nearly 1000 deaths/day; 67 M americans ahve HTN; 1-3 ration; incidence in children increases risk of HTN d/t obesity

2

Why is HTN known as the "silent Killer'?

HTN is not associated w/symptoms that would prompt individuals to seek medical help; severe target organ damage will be the result of un-tx HTN

3

What are the goals of HEALTHY PEOPLE in the reduction of HTN:

healthy weight, reduce NA intake, increase exercise, limit EtOH, know/monitor bld pressure, take medications if ordered

4

What are the types of comorbidities that are a MAJOR contributor to HTN:

heart attack, stroke, HF, kidney failure, cardiovascular disease

5

What ethnicites have the highest HTN incidences:

African/ mexican, Native Americans

6

What area of the US has the highest incidence of HTN regardless of race:

Stroke Belt or southeastern US

7

A persistent/sustained elevation of BP at >140/90 mmHg is defined as:

HTN

8

The classification of HTN is based on what:

The average of two or more office visit occasions

9

Stage 2 HTN is:

>160/100

10

PreHTN is:

120-39/80-89

11

What is the elderly impact of HTN:

Not considered a normal part of aging, but common among pts >60 yo; increases w/age; prone to drug overdosing d/t decreased renal function; Isolated systolic HTN is more common in older adults

12

The force exerted by the blood against the walls of the bld vessels is defined as:

BP

13

The total bld flow through the systemic or pulmonary circulation per min is defined as:

CO (also described as the stroke volume of blood pumped out by L ventricle per beat)

14

The force that opposes the movement of blood within the blood vessels is defined as:

systemic vascular resistance (SVR)

15

What is the principal factor in determining vascular resistance:

The radius of the small arteries and arterioles

16

What happens if the systemic vascular resistance is increased but the CO is the same or increases:

arterial BP increases

17

An elevated BP w/specific causes that can be identified and corrected: narrowing of the aorta, renal disease, endocrine disorders, neurological disorders, sleep apnea, medications, PIH (pregnancy-induced HTN), and pheochromocytoma (adrenal tumor) is defined as what type of HTN:

Secondary HTN

18

An elevated BP w/out identified causes (accounts for 90% of cases) such as: increased activity of the SNS, overproduction of Na retaining hormone, increased Na intake, obesity, excessive EtOH intake, and DM is what type of HTN:

Primary/Essential HTN

19

How does heredity affect HTN:

strongly familial d/t activities/dietary factors; 30 % genetic factor in some populations

20

How does water and NA affect HTN:

Increased Na intake causes water retention; in some degree, NA intake triggers the development of HTN according to studies done on primitive vs. industeralized and salt loading studies

21

Arterial BP increases with the increase of what:

CO or systemic/peripheral vascular resistance

22

How does the renin-angiotensin-aldosterone system affect BP

Decreased BP/SNS stimulation causes renin to to be secreted from the JA of the kidneys-->Renin converts A-1 to A-2-->A-2 increases BP as a vasoconstrictor (increasing SVR), and causes adrenal glands to secrete aldosterone which cause NA and water retention increasing blood volume=increasing CO=increasing BP

23

How does Stress affect HTN:

stress increases the SNS activity-->increased SNS activity causes vasoconstriction, increased HR, and increased renin release

24

How does insulin resistance/hyperinsulinemia affect HTN:

present in PRIMARY HTN (DM); high insulin stimulates SNS activity, impairs nitric oxide mediated vasodilation, vascular hypertrophy, increased Na retention

25

How does endothelial cell dysfunction affect HTN:

contributes to atherosclerosis, High levels of endothelin prolongs vasoconstriction, decreased vasodilator response to nitric oxide

26

How does gender and age play a role in HTN:

HTN is prevalent in males young/middle-age; prevalent in women after 55 yo; BP rises progressively w/increasing age, but HTN is not a normal aging process

27

What are the major target organ complications of HTN:

Cerebrovascular disease, retinopathy; hypertensive heart disease (CAD, LVH, HF); aortic aneurysm; nephrosclerosis, PVD, neuropathy

28

Transient ischemic attack (neurological dysfunction d/t bld loss) or stroke (commonly d/t atherosclerosis); intracranial pressure is a manifestation of what target organ disease:

cerebrovascular disease

29

Narrowing of the retinal arterioles; arteriovenous nicking (arteriole crossing over vein), or hemorrhagic/exudate w/or w/o papiledema (all causing vision blurred/loss of vision/retinal hemorrhage) are manifestations of what target organ complication of HTN:

retinopathy

30

EKG/clinical/radiologic evidence of CAD d/t MI...; LVF/HF; left ventricular dysfunction are manifestations of what target organ complication of HTN:

hypertensive heart disease/cardiac disease