Hypertension Flashcards

1
Q

3 classifications of HTN?

A
  1. )Essential Hypertension
  2. )Secondary Hypertension
  3. )Malignant Hypertension
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2
Q

most common type of HTN

A

Essential/Primary

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3
Q

WHY DOES HYPERTENSION CAUSE PERFUSION PROBLEMS?

A

High pressure leads to microvascular vessel remodeling

  • ->Less capillaries and arterioles in vascular bed
  • ->Decreased tissue perfusion
  • ->TISSUE GETS DAMAGED FROM LACK OF O2
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4
Q

Modifiable and non modifiable risk factors increasing risk of essential HTN

A

Modifiable Risk Factors

  • Weight
  • Diet
  • Alcohol intake
  • Stress level
  • Smoking
  • Exercise level

Non-modifiable

  • Family History
  • Ethnicity
  • Age
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5
Q

this kind o HTN has an underlying cause

A

secondary

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6
Q

common causes of secondary HTN

A
  • Disease
  • Drugs
  • Kidney disease is the most common cause of 2º Hypertension
  • Pregnancy
  • Obstructive sleep apnea
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7
Q

Drugs that cause secondary HTN

A
  • Estrogen replacement
  • Glucocorticoids
  • Sympathomimetics
  • Erythropoietin
  • Cyclosporine
  • NSAIDS and COX-2 inhibitors
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8
Q

JNC8 guidlines for adults >/= 60

A

<150/90

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9
Q

JNC8 guidelines adults 30-59

A

bp <140/90

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10
Q

JNC8 guidelines for 18-29

A

recommendation is on the basis of expert opinion

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11
Q

JNC8 guidelines 18 and older with CKD or diabetes

A

<140/90

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12
Q

AHA guidelines for adults

A

<120/80

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13
Q

AHA says treat anyone whose BP is > ____

A

130/80

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14
Q

Assessment findings for HTN

A
  • Usually, patient has no symptoms
  • May experience
    • Headache
    • Facial flushing
    • Dizziness
    • Syncope
  • History is important in assessing! increases risk of having HTN w/ family hxs
  • the higher the BP = more likely to have sxs
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15
Q

Labs for HTN

A
  • No lab tests for essential hypertension
  • Presence of protein and RBC’s in urine
  • Elevated BUN
  • Elevated creatinine
  • Catecholamines in urine - looks at endocrine issue
  • Elevated serum corticoids (and ketosteroids in urine) - Cushing’s syndrome
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16
Q

Interventions for HTN

A
  • Health Promotion
  • Lifestyle changes
    • Weight loss
    • Low sodium diet (DASH)
    • Exercise
    • Smoking cessation
    • Alcohol restriction
    • Relaxation techniques
  • Plan-of-care adherence
    • Drug therapy
    • Lifestyle changes
17
Q

complications from HTN

A
  • Stroke
  • Heart disease
  • Kidney Disease
  • Retinopathy
18
Q

Who is at risk of Malignant Hypertension?

A

someone w/ uncontrolled HTN

19
Q

Malignant HTN is characterized by

A
  • Rapidly progressing, severely elevated blood pressure
  • Patients are often in their 30’s, 40’s or 50’s
  • Blood pressures greater than 200/130-150
  • Usually symptomatic
    • Headaches
    • Blurred vision
    • Uremia
    • Dyspnea
    • Nose bleed

*Should be treated as emergency or complications will occur

20
Q

Hypertensive emergency interventions

A
  • Check BP in another Arm
  • IV access
  • Cardiac monitor
  • Foley catheter to monitor renal fxn
  • Give IV antihypertensive
  • Oxygen
  • neuro assessment
21
Q

How do we want to reduce BP

A

-Slowly reduce blood pressure

~25% reduction in BP within 2-6 hours

22
Q

Big problem w/ managing HTN?

A

adherence to drugs due to side effects