HTN (Module 4)

Question 1

BP

Answer 1

strength of blood pushing against the sides of the arteries

influenced by CO and systemic peripheral vascular resistance (PVR)

Question 2

BP Regulation

Answer 2

maintained by the ANS

stimulation of the SNS causes tachy, increase contractility and BP (RAAS)…fight or flight response

Question 3

HTN

Answer 3

average BP that is higher than normal over a period of time (2+ office visits)

SILENT KILLER; USUALLY ASYMPTOMATIC

Question 4

MAP

Answer 4

average arterial pressure during a cardiac cycle (indicator of organ perfusion pressure)

> 60 mmHg is enough to sustain organs
<60 mmHg organs aren’t perfused and will eventually become ischemic

Question 5

Pulse Pressure (SBP-DBP)

Answer 5

indicates the health and tone of arterial walls
stroke volume affects pulse pressure

Question 6

Narrowed Pulse Pressure (<40)

Answer 6

poor heart function
lower stroke volume
HF
hypovolemia/bleeding
aortic stenosis
mitral stenosis
regurg

Question 7

Widened/Increased Pulse Pressure (>60)

Answer 7

cardiovascular disease
slow HR
aortic regurgitation
atherosclerosis
HTN
aging

Question 8

OH

Answer 8

decrease in BP by 20 mmHg systolic and 10 mmHg diastolic

Question 9

S3 Heart Sound “Kentucky”

Answer 9

ventricular gallop after S2
normal in elderly, pregnant, adolescents, athletes

SYSTOLIC HEART FAILURE

Question 10

S4 Heart Sound “Tennessee”

Answer 10

atrial gallop before S1
almost always pathological (might be OK in healthy older adults)
stiff ventricle, diastolic dysfunction

left ventricular hypertrophy (LVH)

Question 11

Primary HTN

Answer 11

chronic elevation in BP that occurs w/o disease

can be diastolic, systolic or both

results in damage to vital organs and thickening of arterioles

Question 12

Primary HTN Risk Factors

Answer 12

family history
AA ethnicity
hyperlipidemia
smoking
>60 yo or postmenopausal
excessive sodium/caffeine intake
overweight/obesity
physical inactivity
excessive alcohol intake
low K, Ca, or Mg intake
excessive and continuous stress

Question 13

Secondary HTN

Answer 13

high BP that results from some other disorder

Question 14

Secondary HTN Risk Factors

Answer 14

kidney disease
primary aldosteronism
pheochromocytoma
cushing’s
coarctation of the aorta
brain tumors
encephalitis
pregnancy
drugs (estrogen, glucocorticoids, mineralcorticoids, sympathomimetics)

Question 15

HTN Diagnostics and Labs

Answer 15

serial BP readings
cholesterol lvls
microalbuminuria (small amounts of protein in urine aka kidney damage)

Question 16

Garlic and Coenzyme Q10 ADE (HTN)

Answer 16

bleeding and liver damage

Question 17

ACEi and ARB

Answer 17

angioedema (allergic reaction!)

assess for hyperkalemia

hold for SBP <100

Question 18

BB

Answer 18

hold for HR <50-60 bpm
hold for SBP <90-100

Question 19

CCB

Answer 19

NO GRAPEFRUIT JUICE

Question 20

Diuretics

Answer 20

daily weights important for tracking!

assess for dehydration and electrolyte imbalance

Question 21

Loop and Thiazide Diuretics SE

Answer 21

HYPOkalemia (life threatening dysrhythmias)
HYPOmg

eat foods high in K

Question 22

K Sparing Diuretics SE

Answer 22

HYPERkalemia (life threatening dysrhythmias)
weakness
irregular pulse

avoid foods high in K

Question 23

HTN Nursing Care

Answer 23

commitment to long term therapy is the most importantly goal for someone with HTN

INDIVIDUALIZE PLAN

Question 24

BP Trackers

Answer 24

prepare (no coffee/smoking, empty bladder, sit awhile, no anxiety or exercise)

BP in both arms, relax before testing, single BP is useless (white coat phenomenon)

Question 25

Salt Reduction Education

Answer 25

reduce salt added when preparing foods; avoid/limit consumption of high salt foods like soy sauce, fast foods, and processed foods no more than 2400 mg/day, limit to 1500 mg/day

Question 26

Healthy Diet

Answer 26

reducing food high in sugar, saturated fat, trans fat such as DASH diet increase veggies high in nitrates known to reduce BP like leafy veggies and beetroot high in Mg, Ca, K

Question 27

Healthy Drinks

Answer 27

mod consumption of coffee, green and black tea hibiscus tea, pomegranate juice, beetroot juice and cocoa

Question 28

Moderate of Alcohol Consumption

Answer 28

2 standard drinks for men and 1.5 for women; no binge drinking

Question 29

Weight Reduction

Answer 29

ethnic-specific cut offs for BMI and waist circumference waist-to-height ratio <0.5 is recommended; measure at level of belly button

Question 30

Regular Physical Activity

Answer 30

moderate intensity aerobic exercise for 30 min on 5-7 days a week or HIIT strength training 2-3 days a week

Question 31

Reduce Exposure to Air Pollution/Col Temps

Answer 31

negative effect of air pollution on BP in long term