Vascular Flashcards
1
Q
Classifications & Etiology of HTN - Primary (essential)
A
- Most common type
- Not caused by an existing hlth problem; can develop when a pt has any 1 or more risk factors:
> family hx
> African-American
> hyperlipidemia
> smoking
> older than 60 or postmenopausal
> excessive sodium & caffeine intake
> overweight/obesity
> physical inactivity
> excessive alcohol intake
> low potassium, calcium, or magnesium intake
> excessive & continuous stress
2
Q
Classifications & Etiology of HTN - Secondary
A
- Results from specific diseases & some drugs
- Kidney disease is one of the most common causes of secondary HTN
3
Q
Phsyical Assessment of HTN
A
- Most ppl have no symps
- Some pts experience headaches, facial flushing, dizziness, fainting
- BP screenings:
> take in both arms
> 2 or more readings at a visit
> use appropriate size cuff
4
Q
Orthostatic Hypotension
A
- Dcr in BP w/ changes in position
> 20 mmHg for systolic and/or 10 mmHg for diastolic
5
Q
Psychosocial Assessment for HTN
A
Asseess for stressors tht can worsen HTN
6
Q
Diagnostic Assessment for HTN
A
- No specific testing for primary HTN
- Secondary HTN can be screen w/ labs specific to underlying disease
> EX: kidney disease
7
Q
Interventions for HTN
A
-
Lifestyle changes
> dietary sodium restriction to less than 2g
> reduce weight
> use alcohol sparingly
> exercise 3-4 days a week for 40mins
> use relaxation techniques to dcr stress
> avoid tobacco & caffeine -
Complementary & alternative therapies
> biofeedback
> meditation - Drug therapy
- Avoid OTC meds (NSAIDs & decongestants)
8
Q
Drug Therapy for HTN
Diuretics
A
- 1st line of meds
- dcr blood volume & lower BP
- Hydrochlorothiazide
- Furosemide (Lasix)
- Torsemide (Demadex)
- Spironolactone (Aldactone)
- monitor for hypokalemia w/ thiazide & loop diuretics
- monitor for hyperkalemia w/ potassium-sparing
- educate abt frequent voiding
- monitor for dehydration & orthostatic hypotension
9
Q
Drug Therapy for HTN
calcium channel blockers
A
- Interferes w/ calcium ions causing vasodilation to lower BP
- Verapamil (Calan)
- Amlodipine (Norvasc)
10
Q
Drug Therapy for HTN
angiotensin-converting enzyme (ACE) inhibitors
A
- Blocks angiotension conversion which inhibits vascoconstriction
> vasodilation occurs & BP is lowered - Captopril (Capoten)
- Lisinopril (Prinivil, Zestril)
- Enalapril (Vasotec)
- Common side effect: nagging dry cough
11
Q
Drug Therapy for HTN
angiotensin II receptor blockers
A
- Blocks binding of angiotensin to receptor sites which inhibits vasoconstriction
> vasodilation occurs & BP is lowered - Candesartan (Atacand)
- Valsartan (Diovan)
- Losartan (Cozaar)
- Azilsartan (Edarbi)
- monitor for hyperkalemia
12
Q
Drug Therapy for HTN
aldosterone receptor antagonists
A
- Blocks binding of aldosterone at receptors which inhibits sodium reabsorption
- Eplerenone (Inspra)
- monitor for hyperkalemia
- can interact w/ many other drugs & grapefruit
13
Q
Drug Therapy for HTN
best-adrenergic blockers
A
- Drug of choice for hypertensive pts w/ ischemic heart disease
- Blocks beta receptors whcih dcr HR & myocardial contractility
- sympathetic nervous system is blocked
- Metoprolol (Toprol, Lopressor)
- Atenolol (Tenormin)
- Bisoprolol (Zebeta)
- monitor for orthostatic hypotension
- can cause fatigue, depression, & sexual dysfunction
- angioedema can be side effect
- use w/ caution in pts w/ DM bc glucose production may be affected
14
Q
Venous Thromboembolism Risk Factors
A
- Stasis of blood
- Vessel wall injury
- Altered blood coagulation
15
Q
VTE Prevention
A
- Pt education
- Leg exercises
- early ambulation
- adequate hydration
- graduated compression stocking
- intermittent pneumatic compression; SCDs
- venous plexus foot pump
- avoid oral contraceptives
- anticoagulant therapy
