Module 7 Ch. 28

Question 1

What is the most common chronic disease among US adults

Answer 1

hypertension

Question 2

What is hypertension

Answer 2

Systolic bp of 130 or higher or a distolic over 80

Question 3

What is elevated bp

Answer 3

120-129/<80

Question 4

What is stage 1 hypertension

Answer 4

130-139/80-90

Question 5

What is stage 2 hypertension

Answer 5

> 140/>90

Question 6

What are some symptoms of other oragans from hypertensions

Answer 6

• Retinal/eye changes
• Renal damage
• MI
• Cardiac hypertrophy
• Stroke

Question 7

What are some pathophysicalogic processes

Answer 7

• Increase in CO or peripheral resistance
• Must also be an issue with the bodys control system
• Dysfunction of autonomic NS
• Increase in RAAS
• Activation of immune system

Question 8

What is masked hypertension

Answer 8

BP that suggests hypertension but is normal in healthcare settings

Question 9

What are some abnormal physical findings of HTN

Answer 9

• Absent/weak pulses
• Additional cardiac sounds
• Retinal hemorrhages
• Distended jugular veins
• Renal artery bruit

Question 10

What are some risk factors for developing HTN

Answer 10

• Smoking
• Obsesity
• Physical inactivity
• Dyslipidemia
• Diabetes
• Older age and fam Hx

Question 11

What is an assessment for Hypertension

Answer 11

Hx
Physical exam (retinal exam)
Lab tests (urinalysis and blood chem)
ECG

Question 12

What are some lifestyle modifcations for HTN

Answer 12

• Weight reduction
• DASH diet (reduced na)
• Regular physical activity
• Reduced alcohol consumption

Question 13

What are some medication classes to help with HTN

Answer 13

• Diuteics
• ACE inhibs
• Beta Blockers
• Alpha blockers
• Vasodilators
• ARBs
• Ca Channel blockers
• Direct rennin inhibs

Question 14

What dose do you start with for blood pressure medications

Answer 14

low dose and then increase as needed

Question 15

What are some issues that go with hypertension

Answer 15

• Left ventricular hypertrophy
• MI
• HF
• TIA
• CVA
• Renal insufficiency and chronic kidney disease
• Retinal hemorrhage

Question 16

What are some goals for a patient with hypertension

Answer 16

• Understanding disease and treatments
• Participation in self care program
• Absence of complications

Question 17

What are some interventions of HTN

Answer 17

• Support and educate
• reinforce and support lifestyle changes
• taking meds
• follow ups
• Monitoring complications

Question 18

what are some older adult considerations for HTN

Answer 18

• Remember they might forget to take meds
• Can be expensive for them
• Monotherapy
  -Ensure they understand
• Educate them and family

Question 19

What is a hypertensive emergency

Answer 19

BP of >180/120
- Must be lowered to prevent further damage to organs

Question 20

What is a hypertensive urgency

Answer 20

• BP of >180/120
• NO evidence of immediate or progressive organ damage

Question 21

How fast can we reduce BP for hypertensive emergency

Answer 21

• Reduce to 160/100 in 2-4 hrs
• Then return to normal in 24-48 hrs

Question 22

What medications can we use for hypertensive emergency

Answer 22

IV vasodilators:
- Sodium nitroprusside, nicardipine, nitroglycerin

Question 23

How fast can we reduce BP for hypertensive urgency

Answer 23

with 24-48 hrs to return to normal bp

Question 24

What are some fast acting agents to use for hypertensive urgency

Answer 24

• Beta-adrenergic blockers
• ACE inhibs
• Alpha 2 agonists