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MS2 Exam 2 > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What are we really measuring when we taking someone’s BP?

A

Force of the blood on the arterial wall and vice versa

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2
Q

Why does BP go up when we are in pain?

A

Increased O2 demand

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3
Q

What’s happening to our bodies when our BP is too high?

A

Stroke is most common or MI

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4
Q

How do we define HTN?

A
  • Systolic BP over 140

- Diastolic BP over 90

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5
Q

Pre-HTN

A

120-139 and/or 80-89

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6
Q

Stage 1 HTN

A

140-159 and/or 90-99

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7
Q

Stage 2 HTN

A

over 160 and/or over 100

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8
Q

HTN aka …

A

The Silent Killer

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9
Q

WHO identifies HTN as…

A

being responsible for 62% of cerebrovascular dz and 49% of ischemic heart disease

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10
Q

CDC estimates…

A

that appox. 1 in 4 adults are hypertensive. Many do not realize

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11
Q

What is BP?

A

Force exerted against the walls of the arteries and veins by the blood as its being pumped from the heart

-Remember your physics: also the pressure exerted by the walls of the arteries and veins against the blood

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12
Q

Systolic pressure

A

highest amount of pressure exerted on the arterial wall at the peak of ventricular contraction

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13
Q

Diastolic pressure

A

lowest pressure exerted during ventricular relaxation

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14
Q

MAP

A

Mean Arterial Pressure

-avg amount of pressure exerted throughout cardiac cycle

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15
Q

MAP is measured..

A

as the cardiac output, multiplied by the peripheral vascular resistance

COxPVR=MAP

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16
Q

Pulse Pressure

A

SBP-DBP=PP

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17
Q

Why is MAP important?

A
  • gives us a picture of the entire cardiac cycle
  • monitors the perfusion of organs
  • MAP 70-110 is normal, over 60 is enough to perfuse all organs, less is potentially bad
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18
Q

Sympathetic Nervous System BP control

A

baroreceptors in the carotid arteries can activate SNS

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19
Q

Vascular endothelium

A

produces several vasoactive substances

20
Q

Renal System BP control

A
  • controls extracellular fluid
  • renin, angiotensin, aldosterone
  • prostaglandins - vasodilators
21
Q

Primary HTN

A

elevated BP without a single identified cause

22
Q

Secondary HTN

A

elevated BP with specific cause which can be identified and corrected

23
Q

Preclampsia

A

elevated BP during pregnancy, usually after 20 weeks

-possible organ damage esp kidneys. Very dangerous.

24
Q

Contributing factors of Primary HTN

A
  • Elevated SNS activity
  • Elevated sodium retaining/vasoconstricting hormones
  • Increased body weight
  • Diabetes
  • Tobacco/alcohol consumption
25
Q

Risk factors for HTN

A
  • Age
  • Body weight
  • Diet
  • Exercise
  • Genetics
  • Sex
  • Ethnicity
  • Alcohol/Tobacco
  • Stress
26
Q

Manifestations of HTN

A
  • Early on, asymtomatic, only high BP
  • HA
  • Nocturia
  • Mental status changes later on
  • N/V
  • Visual changes, papilledema (swelling of optic nerve)
27
Q

altered kidney function

A

leads to excess fluid volume and retention

28
Q

CHF and HTN

A

Increased workload, ventricles stretch, hypertrophy, muscle thickens, fluid backs up, increased BP even more

29
Q

Diabetes and HTN

A

Increased blood visocity, increased fluid volume

30
Q

Secondary HTN

A
  • coarctation or congential narrowing of aorta
  • S/E of drugs or hormones
  • Traumatic brain injury, tumors
  • Glomerulonephritis, kidney dz
  • cirrhosis
31
Q

HTN Crisis/ Emergency

A
  • develops over several hours, days, or even weeks
  • situation when BP rises to severe levels
  • rate of rise is more important than the end value however pts with chronic HTN typically tolerate higher BPS normally
32
Q

HTN Crisis Manifestations

A
  • Encephalopathy
  • Renal insufficiency
  • Angina, MI, chest pain, SOB
33
Q

Encephalopathy

A

increased cerebral capillary permeability

  • HA
  • N/V
  • seizures, confusion, edema
34
Q

HTN Crisis Tx

A
  • Aimed at lowering BP immediately
  • nitroprusside sodium
  • labetalol
35
Q

Nitroprusside sodium

A

vasodilator given IV in HTN crisis, must be closely monitored and tightly titrated

36
Q

Labetalol

A

mixed alpha and beta adrenergic blocker given IV

37
Q

Prevention/Tx of HTN Crisis

A
  • Modify diet
  • Increase activity, exercise, decrease weight
  • stress reduction
  • dash diet
  • drugs
  • will depend on individual and the cause of their HTN
38
Q

DASH Diet

A
  • Dietary approaches to Stop HTN
  • Lots of fruits, veges, whole grains, low fat dairy, fish, poultry, nuts
  • very few sugary foods, sugary beverages, red meats, added fats
39
Q

Beta Adrenergic Receptor Blockers

A
  • Atenolol
  • Metoprolol

Make the heart beat slower and with less force

40
Q

Angiotensin Coverting Enzyme Inhibitors

A
  • Enalapril
  • Lisinopril

Stops veins from vasocontricting

41
Q

Diuretics

A
  • Furosemide
  • Hydrochlorothiazide

Makes you pee

K+ sparing, Spironolactone

42
Q

Your patient has been prescribed Toprol XL (Metoprolol) for the treatment of Hypertension. Which change do you expect to occur in your patient as a result of this new prescription?

A

Decrease in HR

43
Q

HTN often goes undetected until symptoms of major organ system failure begin to appear. Which of the following would be the most likely to occur in the patient with HTN?

A

Cerebrovascularaccident

44
Q

Your patient has been prescribed a vasodilator (Hydralazine) for the treatment of HTN. Which side effect do you want to monitor your patient for?

A

Tachycardia

45
Q

Whats happening to our bodies when our BP is too high?

A

Blood vessels are under stress and loses elasticity

MS2 Exam 2 (9 decks)

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