Hypertension

Question 1

What is hypertension?

Answer 1

Force of blood against artery walls that is high enough to cause health problems.

Question 2

What main things are damaged by high blood pressure?

Answer 2

Blood vessels in heart and kidney

Question 3

What systems is blood pressure regulated by?

Answer 3

Cardio
Endocrine
Renal
Nervous (SNS)

Question 4

Baroreceptors monitor what?

Answer 4

Stretch pressure

Looking for drop in B/P

Question 5

Chemoreceptors monitor what?

Answer 5

O2 and CO2

Looking for balance

Question 6

What is RAAS?

Answer 6

Renin
Angiotensin I-if changes to II, B/P gets too high!
Aldosterone

Question 7

Blood pressure =

Answer 7

Cardiac output X Vascular resistance

Question 8

When do the kidney’s release renin?

Answer 8

When B/P if below 100

Question 9

What is the silent killer?

Answer 9

Hypertension

• Might be asymptomatic
• Damage is still being done

Question 10

Normal B/P

Answer 10

120/80

Question 11

Isolated systolic hypertension

Answer 11

> 140 over <90

Question 12

Prehypertension

Answer 12

120-139 over 80-89

Question 13

Stage 1 HTN

Answer 13

140-159 over 90-99

Question 14

Stage 2 HTN

Answer 14

Systolic 160 or higher OR Diastolic 100 or more

*If 180/110-need to be seen immediately!!

Question 15

High systolic and low diastolic is common in what age group?

Answer 15

Mostly old people

Question 16

Types of Hypertension

Answer 16

Isolated Systolic Hypertension (ISH)

Primary Hypertension

Secondary Hypertension

Question 17

What is Isolated Systolic Hypertension (ISH)?

Answer 17

Systolic >140, Diastolic <90

Question 18

Which type of hypertension is most common?

Answer 18

Isolated Systolic Hypertension (ISH)

Question 19

Why does Isolated Systolic Hypertension (ISH) effect individuals older than 50?

Answer 19

**Stiff arteries

-deficient baroreceptors

Question 20

What is Primary hypertension?

Answer 20

Essential or idiopathic hypertension

90-95% of cases

Causes cannot be identified

Question 21

What is secondary hypertension?

Answer 21

High blood pressure from an identified source

5-10% of cases

Treatment aimed at cause

Question 22

What is a major cause of blood pressure to go up?

Answer 22

Smoking-vasoconstrictor

Question 23

Clinical presentation of hypertension

Answer 23

May not have abnormalities

Depends on location of damaged vessels

• EYES
• CAD with angina, MI, HF
• Kidney-edema, proteinuria, renal failure
• CVA, TIA

Question 24

Clinical manifestations of severe HTN

Answer 24

Dull headaches

• doesn’t go away
• If BAD, could bust a vessel

Dizzy spells

Nosebleeds
-not because of dryness

Question 25

How to diagnose hypertension

Answer 25

Echocardiogram-structure & action UA ECG-heart damage Blood tests -BUN, glucose, creatnine, lipid X-ray or US of kidneys UA (creatinine clearance)-24 hr refrigerated-kidney damage

Question 26

Treatment of hypertension

Answer 26

To decrease vascular resistance and blood volume Control blood pressure=decrease CV risk *Look at culture: food, activities

Question 27

Medications for hypertension

Answer 27

``` Diuretics-volume Adrenergic inhibitors Direct vasodilators Angiotensin inhibitors Calcium channel blockers ``` *Lipid lowering drugs

Question 28

OTC hypertension

Answer 28

Nitric oxide-garclic (thins blood) Probiotics-gut health (where immune system is) Omega 3-fish oil will make you bleed Fatty fish=salmon

Question 29

Nursing info for hypertension

Answer 29

- Don't pump B/P higher than brachial pulse - Orthostatic is important! Get pt up slowly! - Older people may not tolerate a B/P lower than 120/?

Question 30

What type of problem effects pulse rate?

Answer 30

Pituitary

Question 31

Lifestyle modifications

Answer 31

- Decrease stroke 35-40% - Decrease MI 20-25% - Decrease HF 50% Dietary can stop HTN - increase fruits, veggies - increase carb, fat

Question 32

Blood pressure is _____ in the morning, and _____ in the evening

Answer 32

higher; lower

Question 33

Blood pressure _____ with age

Answer 33

rises * S-until 80 * D-until 55-60

Question 34

If blood pressure is taken in both arms, use the _______ result

Answer 34

highest

Question 35

What is hypertensive crisis?

Answer 35

Severe, abrupt increase in diastolic blood pressure (defined as >140)

Question 36

What is the most important part of hypertensive crisis?

Answer 36

Rate of increase is more important that actual value *Did it rise quickly or creep up?

Question 37

What often causes hypertensive crisis?

Answer 37

Patients that have failed to comply with medications, who have been under-medicated, or people who have taken illegal drugs.

Question 38

Hypertensive crisis clinical manifestations

Answer 38

May look like a stroke, but can still move Chest pain-can go through to back 180/110-URGENT!

Question 39

MAP

Answer 39

Mean Arterial Pressure Good MAP: 70-110.5 If below 60, brain isn't getting anything.