Hypertension

Question 1

Hypertension Patho

Answer 1

High pressure leads to microvascular vessel remodeling -> less capillaries and arterioles in vascular bed -> decreased tissue perfusion
-Tissue gets damged from lack of O2

Question 2

essential HTN

Answer 2

• Most common type

- Not cause by a preexisting condition

Question 3

Modifiable risk factors

Answer 3

• Weight, diet, alcohol intake, stress level. smoking, exercise level
  Non- modifiable: FM, Ethnicity, Age

Question 4

Secondary HTN

Answer 4

• Identifiable underlying cause : disease or drugs?
• Kidney disease is the most common cause of secondary HTN
• Problems with adrenal medulla
• pregnancy
• obstructive sleep apnea

Question 5

Secondary HTN drug causes

Answer 5

• estrogen
• glucocorticoids
  -sympathomimetics
• Erythropoietin
  -Cyclosporine
  NSAIDs and COX-2 Inhibitors

Question 6

JNC 8 guidelines

Answer 6

Age 60 and up: BP should be less than 150/90

30-59: 140/90

18-29: based on expert opinion

18 and older w/ CKD or DM: BP should be less than 140/90

Question 7

Assessment HTN

Answer 7

No symptoms typically
- may experience
headache, facial flushing, dizziness, syncope

Question 8

Diagnostics

Answer 8

• 3 bp readings
• presence of protein and RBCS
• Elevated creatinine
• Catecholomines in urine
• ELevated serum corticoids

Question 9

Nursing diagnosis

Answer 9

• Potential for reduced adherence to anti-hypertensives due to side effects of medication
• Ineffective tissue perfusion related to chronically elevated BP as manifested by target tissue damage
• Knowledge deficit related to hypertension as manifested by lack of understanding regarding adverse effects of elevated BP

Question 10

Intervetions

Answer 10

Lifestly changes: weight loss, low sodium (DASH), Exercise, smoking cessation, alcohol restriction, relaxation techniques
ADHERENCE!!

Question 11

High sodium diets are

Answer 11

processed foods

Question 12

Complications

Answer 12

-stroke, heart disease, kidney disease, retinopathy

Question 13

Malignant HTN

Answer 13

• rapidly progressing
• patients are in 30s- 50s
• BP is greater than 200/130-150

Usually symptomatic

Question 14

Symptoms of Malignant HTN

Answer 14

Headaches, blurred vision, uremia, dyspnea, nose bleed

needs to be treated or complications will occur

Question 15

Interventions for HTN emergency

Answer 15

Monitor: cardiac monitor

• neuro assessments
• Urinary output

IV access

• IV antihypertensives
• slowly reduce blood pressure: - 25% reduction in BP within 2-6 hours
• Oxygen