Module 6b Hypertension

Question 1

BP Classification Systolic BP (mm Hg) Diastolic BP (mm Hg) Normal

Answer 1

< 120 and < 80

Question 2

Elevated
Hypertension Stage 1
Hypertension Stage 2
Hypertensive Crisis

Answer 2

Elevated 120 - 129 and < 80
Hypertension Stage 1 130 - 139 or 80 - 89
Hypertension Stage 2 > 140 or > 90
Hypertensive Crisis > 180 and/or > 120
Learning Outcome: Define the categories of abnormal b

Question 3

HYPERTENSION & CLINICAL MANIFESTATIONS

Answer 3

• Hypertension is classified as primary and secondary. Primary hypertension is about 95% of the patient. The cause cannot be determined although probably results from environmental (e.g. lifestyle) and genetic factors. Secondary hypertension is caused by other disease, usually endocrine (e.g. Cushing syndrome)
• Hypertension is a silent killer because people who have it are often symptoms free. With prolonged high BP, it damages the blood vessels (endothelium). Inflammation in the endothelium causes atherosclerotic disease (dyslipidemia) which contribute to myocardial infarction (MI), cerebrovascular accident (CVA) and chron

Question 4

GERONTOLOGIC CONSIDERATIONS

Answer 4

● Elevated in systolic blood pressure in isolation
- Decrease elasticity and the accumulation of atherosclerotic plaque in the major blood vessels - Volume expansion associated with structural and functional changes in the kidney - Changes in the strength of cardiac contraction
● Consider less rigid blood pressure control to target less than 150/90. Lower target may increased risk for orthostatic hypotension putting older adults at risk for falls and fractures.
● Be aware of finances and drug interactions among older adults, thus if appropriate consider a monotherapy for blood pressure control

Question 5

Formula BP

Answer 5

BP = CO x PVR

SV x HR (1 minute)

Increase in blood pressure is related to increase in cardiac output (CO) and constriction of the blood vessels. Increase CO is associated with volume expansion.

Question 6

ASSESSMENT & DIAGNOSTIC FINDINGS

Answer 6

● URINALYSIS & URINE TEST
- Presence of protein in the urine, particularly the amount of macroalbuminuria/microalbuminuria; 24 hours urine creatinine & protein

● BASIC METABOLIC PANEL (BMP) 
SODIUM 
CHLORIDE 
BUN 
GLUCOSE 
Diabetes Mellitus -CO2 POTASSIUM 

CREATININE - Kidney Functions

Question 7

ASSESSMENT & DIAGNOSTIC FINDINGS

Answer 7

● LIPID PROFILE
- High level cholesterol, low-density lipoprotein (LDL), Triglycerides / Low level high-density lipoprotein (HDL) contribute to myocardial infarction and stroke
● 12 LEAD ELECTROCARDIOGRAM (EKG)
- Provides information of the rhythm of the heart
● ECHOCARDIOGRAPHY
- Ultrasound of the heart that provides moving pictures and information of the structure and function of the heart (e.g. left ventricular hypertrophy)

Question 8

● LIPID PROFILE

-

Answer 8

High level cholesterol, low-density lipoprotein (LDL), Triglycerides / Low level high-density lipoprotein (HDL) contribute to myocardial infarction and stroke

Question 9

● 12 LEAD ELECTROCARDIOGRAM (EKG)

Answer 9

• Provides information of the rhythm of the heart

Question 10

● ECHOCARDIOGRAPHY

Answer 10

• Ultrasound of the heart that provides moving pictures and information of the structure and function of the heart (e.g. left ventricular hypertrophy)

Question 11

● HYPERTENSIVE EMERGENCY

Answer 11

• Life-threatening blood pressure that requires immediate treatment to prevent target organ damage (e.g. myocardial infarction, intracranial hemorrhage)
• Use of intravenous vasodilators to gradually decrease blood pressure ●

Question 12

HYPERTENSIVE URGENCY

Answer 12

• Blood pressure is very elevated but there is no evidence of target organ damage - Fast-acting antihypertensive oral medication is recommended for treatment