What could be causing the blood to not be flowing where it needs to go?
- Blockage
- Clot
- Vasoconstriction
- Stretched out Veins
How is the heart being an effective pump?
- Is it generating a good cardiac output (the quantity of blood pumped by the heart in a min)
- Are the organs being perfused
** The lower the cardiac output, the poorer the perfusion to organs and extremities.
What could be causing the heart to not be pumping effectively?
- Ischemic/ Infarct Tissues
- Heart Failure
- Valve Problems
(HTN Guidelines)
Elevated:
Stage 1:
Stage 2:
HTN Crisis:
Elevated: Systolic between 120-129 and diastolic less than 80 mm Hg
Stage 1: Systolic between 130-139 or diastolic between 80-89 mm Hg
Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg
HTN Crisis: Systolic over 180 and/or diastolic over 120
What can cause secondary Hypertension?
- Renal Vascular Disease
- Valve Disorders
- Sleep Apnea
- Pregnancy
- Thyroid Disorders
- Drugs:
- Oral contraceptives
- Antihistamines
- Corticosteriods
What does continued HTN do to the blood vessel?
- Hypertrophy: an increase and growth of muscle cells.
- Hyperplasia: the enlargement of an organ or tissue caused by an increase in the reproduction rate of its cells
- Inflammatory Response
HTN Increased Risk Factors: 11
- Family history
- Increasing age
- Cigarette smoking
- Obesity
- Heavy alcohol consumption
6 .Black race - Men (early to middle adulthood)
- Women (over 50yrs)
- High dietary sodium intake
- Low dietary intake of K+, Ca++, Mg++
- Glucose intolerance
S/S of hypertension: 7
- Asymptomatic
- Headache
- Visual disturbances
- Chest pain
- Flushed face
- Epistaxis: nose bleed
- Dizziness
What is complicated HTN?
Sustained Hypertension that has effects beyond hemodynamics.
** two major mechanisms of tissue damage:
- edema and ischemia
Evaluation of HTN includes what?
Auscultation most accurate
Sit quietly at least 5 min
Arm at heart level
Appropriate sized cuff
Treatment options for HTN?
- Lifestyle modifications
- Diet:
- DASH (Dietary Approaches to Stop Hypertension)
- Exercise
- Moderate alcohol consumption
Anti-hypertensive Drugs include what?
ACE Inhibitors
BETA Blockers
Calcium Antagonist
ACE Inhibitors:
- End in -PRIL
- Capoten (CaptoPRIL)
- Vasotec (EnalaPRIL)
- Lotensin (BenazePRIL)
Beta-Blockers:
- End in OLOL
2.
Calcium Antagonists
Alpha- Adrenergic Antagonists ( Alpha- Blockers)
Side Effects:
- Orthostatic Hypo-tension
- Vertigo
- Tachycardia
- Sexual Dysfunction
EX: Doxazosin (Cardura)
Prazosin (Minipress)
