1
Q
Hypertension
A
- systolic: ≥ 130
- diastolic: ≥ 80
2
Q
Elevated BP
A
120-129 (sys) and <80 (dia)
3
Q
Stage 1 HTN
A
130-139 or 80-89
4
Q
Stage 2 HTN
A
≥140 or ≥90
5
Q
Isolated systolic HTN
A
> 130 and < 80
-common in >50 yrs
6
Q
Primary HTN
A
- stress & increased SNS
- insulin resistance & hyperinsulinemia
- endothelial cell dysfunction
- altered renin-angiotensin
7
Q
Primary causes
A
- environmental/demographic/genetic
- water & sodium retension
8
Q
Age Risks for primary
A
- > 50 yrs old SBP more vital (CVD)
- normotensive at 55
9
Q
Secondary HTN
A
elevated BP with a specific cause
10
Q
HTN Manifestations
A
- mostly asymptomatic
- fatigue
- dizziness
- palpitations, angina
- dyspnea
11
Q
HTN complications
A
- heart disease
- cerebrovascular disease
- peripheral vascular disease
- nephrosclerosis
- retinal damage
12
Q
HTN Diagnostics
A
- urinalysis & uric acid
- ECG
- basic metabolic panel
- CBC
- lipid profile
13
Q
HTN Lifestyle modifications
A
- weight loss of 10 kg (22 lb)
- diet rich in veggies, fruit, & nonfat dairy
- <2.3 g of sodium/day
- decrease alcohol (men: 2, women: 1)
- aerobic exercise 30 min
14
Q
First Line Meds for HTN
A
- thiazide diuretics
- ACE inhibitors
- ARBs
- calcium channel blockers
15
Q
Second Line
A
- loop diuretics
- beta blockers
- alpha 1 blockers
16
Q
Bumetanide (Bumex)
A
- loop diuretic
- watch for orthostatic hyptension, dizziness, GI upset
17
Q
Calcium Channel Blockers
A
- Very (verapamil) Nice (nifedipine) Drugs (diriazem)
- decrease contractility/conductivity/demand for oxygen
- don’t take with grapefruit
- SE: bradycardia
18
Q
Ace Inhibitors
A
- ends with pril
- decrease peripheral vascular
- SE: dizziness, orhtostatic hypotension, first dose syncope
19
Q
Alpha Blockers
A
- cardura (blocker), catapres, & aldomet (antagonists)
- SE: orthostatic, vertigo, palpitastions, sexual dysfunction
20
Q
Beta Blockers
A
- B1: heart, B2: lungs
- decrease HR/force of contraction/A-V conduction
- inderal, tenormin, lopressor
- SE: bradycardia, hypotension, CHF, lethargy
21
Q
Nitroglycerin
A
- vasodilator
- SE: hypotension, tachycardia, dizziness
22
Q
Older Adults
A
- white coat HTN
- auscultatory gap
- orthostatic hypo
23
Q
Hypertensive Crisis
A
- > 140 DPB
- in patients with history of HTN
- leads to: encephalopathy, ARF, MI, & heart failure
24
Q
Crisis Care
A
- IV drug therapy: titrated to mean arterial pressure
- monitor cardiac/renal function
- neuro checks
- determine cause
- education
25
The nurse teaches a group of patients diagnosed with hypertension that influencing factors related to rising blood pressure are associated with which physiological processes?
- vasoconstriction
- increased blood viscosity
- increased CO
- increased blood volume
26
The clinic nurse caring for a group of essential hypertension patients understands this disease process is influenced by which contributing factors?
- increased SNS
- increased sodium-retaining hormones
- excessive alcohol intake
27
The nurse hears the patient state to a family member, "My ears are ringing all the time." The nurse assesses the patient and reviews the medication record for drugs with the side effect of tinnitus. Which medication(s) is the nurse expecting to find on the medication administration record?
aspirin and furosemide
28
The nurse recognizes which adverse reaction associated with ACE inhibitors is the most common and typically leads to disruption of therapy?
cough
29
Spironolactone (aldactone)
potassium sparing diuretic
30
Losartan (cozaar)
ARB
31
The nurse anticipates holding which medication for a client with heart rate of 50.
beta blocker
