Shared Flashcard Set

Details

NURS 4210 Exam III
Hypertension
43
Nursing
Undergraduate 4
10/10/2011

Additional Nursing Flashcards

 


 

Cards

Term
The most common PRIMARY diagnosis based on 2 or more BP > 140/90 (does not have to be both)
Definition
HYPERTENSION
Term
Blood Pressure is:
Definition
  • tension or pressure exerted by blood against ARTERIAL walls. 
  • It is the product of cardiac output multiplied by peripheral resistance or systemic vascular resistance (SVR)
Term
Hypertension is:
Definition
Excess pressure in arterial portion of systemic circulation.
Term
Hypertension is called a "silent killer" because:
Definition
Most clients with hypertension are asymptomatic.
Term
Medications used in treating hypertension focus on:
Definition
  • Decreasing Systemic Vascular Resistance
  • Decreasing Blood Volume
  • Decreasing the strength and rate of myocardial contractions.
Term
What does hypertension  do to the body?
Definition

It increases the workload of the left ventricle which must pump hard to eject blood into the arteries which eventually causes hypertrophy and HF.

Term
Prehypertension is defined by:
Definition

BP 

Systolic 120-139 or Diastolic 80-89    

 

Term
Stage I Hypertension
Definition

BP

Systolic 140-149 or Diastolic 90-99

Term
Stage 2 Hypertension
Definition

BP

Systolic > 160 or Diastolic > 100

Term
What is primary hypertension?
Definition

Don't know what is causing it.

 

90-95%

Term
What is secondary hypertension?
Definition
  • Due to a discernable cause such as:
  • identified cause, renal artery stenosis (narrowed artery causing increased pressure and less excretion of wastes.)
  • Hyperaldosteronism
  • Meds such as Aderol and Cocaine, ADD meds and cold meds
  • Pregnancy
  • Coarctation of the Aorta (transposed circulation of blood)
Term
The incidence of hypertension os greater in:
Definition
Southeastern US and among African Africans
Term
The major risk factors for Hypetension
Definition

Smoking                Obesity

Menopause           Family History

Male                       DM

>60                     Activity

Term
Blood Flow is:
Definition
  1. The volume of blood transported.
  2. Commonly expressed as liters or mL per minute or cubic centimeters per second.
Term
Peripheral Vascular Resistance
Definition
  • The opposing forces or impedance to blood.
  • Determined by blood viscosity, length of vessel, and diameter of vessel.

 

Term
What does the SNS do in relation to BP
Definition
Causes vasoconstriction of arterioles, increasing BP
Term
What  does PNS do in relation to BP?
Definition

Causes vasodilation of arterioles, lowering BP

 

***Anything that stimulates PNS will lower BP***

Term
Primary Hypertension Pathophysiology resulting in increased blood volume and peripheral resistance.
Definition
  • Sympathetic nervous system overactivity
  • Renin-angiotensin-aldosterone sys overactivity
  • Chemical mediator of vasomotor tone (atrial natriuretic peptides)
  • Interaction between insulin resistance and endothelial function.

 

Term
Sustained HTN affects other body systems
Definition
  • Accelerates rate of atherosclerosis increasing risk of CHD and stroke, PVD, and aneurysms
  • Workload of left ventricle increases leading to left ventricle hypertrophy and increasing the risk of CHS, dysrhythmias, and HF
  • Leads to nephrosclerosis (stiff) and renal insufficiency.
Term
Environmental Affects on HTN
Definition

Cold causes vasoconstriction which increase BP

 

Heat causes vasodilation which decreases BP

Term
Chemicals, Hormones, and Drugs affect on HTN
Definition

Influence blood pressure by affecting cardiac output and / or peripheral vascular resistance.

Term
Dietary Factors of Hypertension
Definition
Salt, sat fats and cholesterol  elevate blood pressure by affecting blood volume and vessel diameter (narrow passages of arteries and increase BP)
Term
Late Manifestations of HTN
Definition
  • Headache near back of head and neck occurs when awakened and subsides during day.
  • May develop s/s if other organs involved such as confusion, nausea, vomiting, visual disturbances (such as halos or stars)
  • Eye exam will show narrowed arterioles, hemorrhages, an papilledema
Term
How is HTN managed?
Definition

Lifestyle modifications

Pharmacologic Treatment

Prevention of complications

No-cure control

No Dx tests for essential HTN except BP measure

Term
The ultimate public health goal of antihypertensive therapy is:
Definition
  • The reduction of cardiovascular and renal morbidity and mortality as it relates to HTN
  • Treating SBP and DBP to targets of <140/90 is associated with decreased CVD
  • Patients with diabetes or renal disease the goal is <130/80 mmHg
Term
Lifestyle modifications r/t to HTN
Definition
  • Weight reduction
  • Physical activity (mainly cardio)
  • Moderation of alcohol consumption
  • Diet rich in potassium and calcium and low in sodium (DASH, Dietary approaches to stop HTN)
  • Increase lagunes, beans, fiber and decrease in all fast food type food.
Term
Pharmacologic Treatment
Definition
  • ACE inhibitors
  • ARB's: ACE's and ARBS lower BP by causing dilation of vessels.
  • Beta Blockers
  • CCB's
  • Thiazide-type diuretics
Term
The first line of defense against HTN  that is virtually unsurpassed in preventing the cardiovascular complications of HTN and the reason for using them:
Definition

Diuretics

  1. They enhance antuhypertensive efficacy of multidrug regimens
  2. They are affordable
  3. You can use them in combination with other drugs.

 

Term
Interventions with Diuretics
Definition
  • Watch Potassium, sodium, and calcium :(lasix lowers electrolytes and aldactone is potassium sparing.
  • Monitor for s/s of hypokalemia which are dysrhythmia, constipation, fatigue/muscle weakness, spasms or paralysis which can include lungs.
  • Give early in the day to keep from nocturia.

 

Term

ACE INHIBITORS

 

End in prils

Definition
  • Renoprotective
  • Cause peripheral blood vessel dilation
  • Used commonly in patients with ischemic heart disease, HF, diabetic HTN
  • Watch for cough
  • Avoid in women of childbearing age (Teratogenic)
  • watch for hx of angioedema
  • Can also cause elevated potassium level
Term

Angiotensin II Antagonists

(Don't raise potassium as much)

 

Meds end in Sartan

Definition
  • Blocks the binding of Angiotensin II on its receptors resulting in decreased Aldosterone (controls reabsorption of sodium and chloride and secretion of potassium and hydrogen.
  • Reduces left ventricular hypertrophy
  • Common side effect is cough.

 

Term

Calcium Channel Blockers

 

End in "Pine", Verapamil; Diltiazem

Definition

Dilate peripheral arterioles and reducing peripheral resistance.

Used for cardiovascular resistance

Avoid in HF and post MI

***Good results with African American and patients  with breathing problems***

Term

Beta Adrenergic Blockers

"lol"

Definition

Reduce CO by producing beta adrenergic blockage

Most commonly used with diuretics

Avoid with pulmonary patients, diabetic patients

Used with ischemic heart disease.

Slows HR (must be >60 to administer)

 

Term
The common side effects of antihypertensives:
Definition

Bradycardia              Headache

Palpitations            Hypoglycemia

Cough w/ ACE's and ARBS

Dizziness                  Fatigue

Erectile dysfunction         decreased libido

Postural hypotension and hypotension

Term
Secondary Hypertension
Definition

Elevated bp from identifiable underlying condition (5-10%)

Kidney disease

Coarction of aorta

 

Term
Hypertensive Emergency must be lowered immediately to prevent:
Definition

Target Organ Damage such as MI, dissecting aortic aneurysm, Intracranial pressure.

 

Use vasodilators such as : Nitropress, Vasotec, Nitro Bid stat IV

Term
MEDS YOU NEED TO KNOW in relation to HTN
Definition
  • Diuretics: Hydrochlorathiazide, Lasix, Aldactone
  • Beta Blockers: Tenormin, Lopressor, Inderal
  • Calcium Channel Blockers: Norvasc, Calan
  • ACE Inhibitors: Capoten, Vasotec
  • ARBS: Altacand, Cozaar
Supporting users have an ad free experience!