Circulation: P&m Of Htn/pvd

Front 1

The parameters classifying normal B/P are _______/_______.

Back 1

< 120mmHg SBP/ < 80mmHg DBP

Front 2

The parameters classifying pre-hypertension B/P are _______/_______.

Back 2

120-139mmHg SBP/ 80-89mmHg DBP

Front 3

The parameters classifying Stage 1 hypertension B/P are _______/_______.

Back 3

140-159mmHg SBP/ 90-99mmHg DBP

Front 4

The parameters classifying Stage 2 hypertension B/P are _______/_______.

Back 4

>/= 160mmHg SBP/ >/= 100mmHg DBP

Front 5

Persistent elevation of SBP >/= 140, DBP >/= 90 or current use of anti-hypertensive medications make up the definition of _________?

Back 5

Hypertension

Front 6

In the mechanism of action of aldosterone: the aldosterone level increases or decreases?

Back 6

Increases

Front 7

In the mechanism of action of aldosterone: sodium reabsorption increases or decreases?

Back 7

Increases

Front 8

In the mechanism of action of aldosterone: H2O reabsorption increases or decreases?

Back 8

Increases

Front 9

In the mechanism of action of aldosterone: the blood volume increases or decreases?

Back 9

Increases

Front 10

In the mechanism of action of aldosterone: cardiac output increases or decreases?

Back 10

Increases

Front 11

Elevated BP without an identified cause is characteristic of which classification of BP disorder?

Back 11

Primary (Essential or Idiopathic) Hypertension (makes up 90-95% of all cases)

Front 12

Elevated BP with an identified cause is characteristic of which classification of BP disorder?

Back 12

Secondary Hypertension (makes up 5-10% of all cases)

Front 13

What is more important for persons over 50 as a CVD risk factor between SBP & DBP?

Back 13

Systolic blood pressure

Front 14

What four risk factors for primary hypertension can not be controlled or changed?

Back 14

1) Family history
2) Ethnicity
3) Age
4) Gender

Front 15

The proper procedure for gaining an accurate BP are_______?

Back 15

Patient should be seated quietly in a chair for 5 min, feet on the floor and arm supported at heart level.

Front 16

White coat phenomenon may precipitate the need for _______?

Back 16

(ABPM) ambulatory blood pressure monitoring: which uses a noninvasive, fully automated system that measures BP at present intervals over a 24h period.

Front 17

The two main overall goals related to hypertension collaborative care are ______ & _______?

Back 17

1) Control blood pressure
2) Reduce CVD factors

Front 18

What lifestyle modification regarding diet does the National Heart & Lung institute promote?

Back 18

DASH eating plan (Dietary Approaches to Stop Hypertension)

Front 19

Weight loss of 10kg (22lbs) can decrease SBP by about how much?

Back 19

approximately 5-20 mmHg

Front 20

What is the recommended sodium intake in regards to hypertension?

Back 20

< 2.4g sodium/day

Front 21

For hypertension care regarding alcohol intake, what is the maximum suggested intake for males and females?

Back 21

1) Males: no more than 2 drinks/day
2) Females: no more than 1 drink/day

Front 22

What are the 7 S's regarding extremely high sodium foods?

Back 22

Soups, snacks, sauces, smoked meats, sauerkraut, seasonings, & sodium processed cold cuts

Front 23

What lifestyle modification regarding physical activity should be made with hypertension?

Back 23

Regular (aerobic) physical activity at least 30 min, most days of the week

Front 24

Two primary actions of hypertension drugs are ______ & _____?

Back 24

1) Reduce systemic vascular resistance
2) Reduce volume of circulating blood

Front 25

What four drug classifications are used to treat hypertension?

Back 25

1) Diuretics
2) Adrenergic inhibitors
3) Angiotension inhibitors
4) Calcium channel blockers

Front 26

What are 6 nursing diagnoses related to hypertension?

Back 26

1) Ineffective health maintenance
2) Ineffective therapeutic regiment management
3) ineffective tissue perfusion
4) Anxiety
5) Sexual Dysfunction
6) Disturbed body image

Front 27

What ethnicity has the most prevalent and increased risk for hypertension?

Back 27

African Americans

Front 28

A severe & abrupt increase in BP, arbitrarily defined as a BP more than 140mmHg is known as _______?

Back 28

Hypertensive crisis

Front 29

BP that is severely elevated with evidence of acute target organ damage is known as a _________?

Back 29

Hypertensive emergency

Front 30

What does MAP stand for and how is it calculated?

Back 30

Mean arterial pressure, calculated SBP+ 2 DBP then divided by 3
(ex. 120 + 70+70 = 260 divided by 3 = MAP of 87 (86.6666)

Front 31

What medication classification do you not drink grapefruit juice within 2 hours of taking and why?

Back 31

Calcium channel blockers, grapefruit juice increases the blood level of CCB's

Front 32

Amlodipine, Felodipine, Nifedipine, Nisoldipine, and Statins belong to what med classification?

Back 32

Calcium channel blockers

Front 33

The brand name for the calcium channel blocker nifedipine is ______?

Back 33

Procardia

Front 34

The brand name for the calcium channel blocker amlopidine is ______?

Back 34

Norvasc

Front 35

The brand name for the calcium channel blocker nicardipine HCl is ______?

Back 35

Cardene

Front 36

What meds end with suffix Pril ?

Back 36

ACE inhibitors

Front 37

What side effects are expected in 10-20% of patients taking ACE inhibitors?

Back 37

Cough; Hypotension with 1st dose, Increased K+

Front 38

What 2 patient categories do not respond well to ACE inhibitors?

Back 38

African American (unless taken with diuretic) & Elderly

Front 39

4 common ACE inhibitors are?

Back 39

Prinivil, Accupril, Captopril, Benazepril

Front 40

How does an ACE inhibitor work?

Back 40

It inhibits the formation of ANGIO II (constrictor) & Blocks aldosterone. Works on peripheral resitance (SVR).

Front 41

Blocking aldosterone with an ACE inhibitor causes what to happen?

Back 41

H2O and Na are excreted and K+ is retained.

Front 42

What does the ACE stand for in ACE inhibitor?

Back 42

Angiotensin converting enzyme

Front 43

How do Angiotensin receptor blockers work?

Back 43

Similar to ACE inhibitors, acts on renin-angiotension system, blocks angio II at receptor sites in tissues, prevents release of aldosterone (Na+ retain hormone).

Front 44

What group are angiotensin receptor blockers less effective in?

Back 44

African Americans

Front 45

What is a common side effect with angiotension receptor blockers?

Back 45

angioedema

Front 46

losartan potassium (Cozaar), Valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand) are common meds for what classificiation?

Back 46

Angiotensin receptor blockers

Front 47

Cardizem, Norvasc, Syscor, Verapamile are common meds for what classificiation?

Back 47

Calcium channel blockers

Front 48

Common side effects of CCB's are?

Back 48

flushing, HA, dizziness, bradycardia, AV block

Front 49

Calcium channel blockers lower BP better in this group better than drugs in other categories.

Back 49

African Americans

Front 50

How do calcium channel blockers work?

Back 50

decrease calcium levels which promotes vasodilation. (heart muscle uses Ca+ to contract, free Ca+ increases systemic vascular resistance (SVR) which increases muscle contraction & B/P)

Front 51

Which diuretic work at the distal convoluted tubule to get rid of Na+, Cl, & H20. Is used in treatment of edema & HTN, and moderate decrease in BP is evident in 2-4 weeks?

Back 51

Thiazides and related diuretics

Front 52

How often does a person's total blood volume go through the kidneys for cleaning?

Back 52

Every 1 1/2 hours

Front 53

Can Thiazides and related diuretics be used in patients with renal failure?

Back 53

No

Front 54

Common side effects for Thiazides & related diuretics are?

Back 54

hypokalemia, hypomagnesemia, hyperlipidemia, hypercalcemia, hyperglycemia, HC03 loss.

Front 55

What is a common form of Thiazide & related diuretics?

Back 55

HCTZ (hydrochlorothiazide)

Front 56

Common side effects of loop diuretics are?

Back 56

fluid & electrolyte imbalances (decreased K+, Na+, Ca+, Cl-, Mg, metabolic alkalosis, orthostatic hypotension)

Front 57

Are loop diuretics potent or non-potent diuretics?

Back 57

Potent (they promote diuresis; inhibit reabsorption of Na+ 2-3 times more effectively

Front 58

Are the effects of loop diuretics slow or fast?

Back 58

Fast

Front 59

Most common drug used in this classification?

Back 59

LASIX (furosemide)~never combined with another loop diuretic

Front 60

How does a loop diuretic work?

Back 60

Inhibit the body's ability to reabsorb Na+ at the ascending loop of Henle, leads to a retention of H20 in the urine as H20 normally follows sodium back into the extracellular fluid. Have a “high celing” (causes a substantial diuresis - up to 20% of the filtered load of NaCl & H20. This is huge, compared to that normal renal sodium reabsorption leaves only ~0.4% of filtered sodium in the urine). Can increase dose to increase response, less effecting for Tx of HTN, can use w/ESRD

Front 61

Common side effects for K+ sparing diuretics

Back 61

hyperkalemia, decreased excretion of hydrogen, calcium, magnesium, nausea, vomiting, diarrhea, rash, dizziness, headache, weakness, dry mouth

Front 62

Are K+ sparing diuretics considered to be potent or non-potent?

Back 62

not potent

Front 63

Are K+ sparing diuretics considered to have fast or slow effects?

Back 63

Fast (but not as fast as loop/thiazides)

Front 64

Common K+ sparing diuretics are

Back 64

amiloride HCL (Midamor), eplerenone (Inspra), triameterene & hydrochlorothiazide (Dyazie, Maxzide)

Front 65

How does a K+ sparing diuretic work?

Back 65

Works on collecting distal duct facilitating Na+ & H20 loss & K+ retention. (Na+/K+ pump = Na+ out, K+ in). Weaker than thiazide & loop diuretics. Mild, can be used with other diuretics, don’t take K+ supplement, don’t use with ESRD. Can use with ACE inhibitors and Angio-II blockers

Front 66

How do Aldosterone receptor blockers work?

Back 66

Cause the kidneys to get rid of extra salt and fluid, & they help hold on to (retain) potassium by inhibiting the action of the hormone aldosterone. Because of this, they are called potassium-sparing diuretics.

Front 67

Are Aldosterone receptor blockers considered potent or not potent?

Back 67

Potent

Front 68

Do Aldosterone receptor blockers have fast or slow effects?

Back 68

Fast

Front 69

Common side effects for Aldosterone receptor blockers

Back 69

hyperkalemia, N/V, leg cramps, dizziness

Front 70

Common aldosterone receptor blockers are:

Back 70

Inspra (eplerenone~approved by FDA for Tx of HTN), Aldactone (spironolactone)

Front 71

Beta blockers can't be use in what types of patients?

Back 71

COPD & 2nd & 3rd degree AV block & CHF & Bradycardia

Front 72

Do African Americans respond well to beta blockers? Why/why not?

Back 72

No. Due to them typically having low renin levels.

Front 73

What are major side effects that occur from beta blockers?

Back 73

decrease HR & severe decrease in B/P & bronchoconstriction

Front 74

Can beta blockers be suddenly D/C'd? why/why not?

Back 74

No, It can cause rebound hypertension.

Front 75

How do beta blockers lower blood pressure?

Back 75

Beta Blockers reduce the effect of excitement/physical exertion on heart rate & force of contraction, dilation of blood vessels & opening of bronchi, & also reduce tremor and breakdown of glycogen

Front 76

How many known types of beta receptors are there?

Back 76

3; designated B1, B2, B3.

Front 77

Where are B1 receptors located?

Back 77

Adrenergic receptors are located mainly in the heart and in the kidneys

Front 78

Where are B2 receptors located?

Back 78

Adrenergic receptors are located mainly in the lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle

Front 79

Where are B3 receptors located?

Back 79

receptors are located in fat cells.

Front 80

How do kidneys aid in blood pressure regulation?

Back 80

By controlling sodium excretion & ECF ( extracellular fluid) volume.