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88 Cards in this Set
- Front
- Back
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pre htn value
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120-140 SYS or
80-90 DIAS |
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Stage 1 htn reading
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140-160 sis
or 90-100 dia |
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stage 2 htn reading
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over 160 sis
or over 100 dia |
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primary method for modifying pre htn
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lifestyle
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method for managing staged htn
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medicine
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what do pts have more primary or secondary htn
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primary.
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why is it called silent killer?
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symptom free
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htn often accompanies other risk factors of what disease
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atherosclerotic
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what are risk factors of atheroclerosis?
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dyslipid
obese DM MS lifestyle |
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what 3 ways can htn be viewed?
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sign
risk factor disease |
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htn is usually heard in elderly as...
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ausc gap
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where is the ausc gap?
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bt first korotkoff and subsequent beats
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what organs are effected by longterm htn?
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heart
kidney brain eyes peripheral vasculature |
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consequences of long bp elevation? think about organs that are damaged
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MI
CHF renal fail stroke impaired vision hypertrophy of left ventricle |
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what says hypertrophy is happening?
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ECG
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htn has been associated with a single gene mutation associated with what?
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mechanisms used by kidneys to reabsorb Na
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some causes of htn? (5)
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fail ANS
High Renal reabsorp. of Na, Water, and Cl High activity of renin-angiotension-aldosterone decreased vasodilation resist insulin action |
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stiffening of vasculature causes what?
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isolated sys
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decreased sensitivity does what?
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causes orthostatic hypotension
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orthostatic htn happens in what pts?
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isolated sys htn
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whats the values of ortho hypotension?
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SBP decrease of 20 or more
DBP decrease of 10 or more HR increase of 20beats/min or when changing from sitting to standing |
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correct cuff width
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1" visible skin above and below cuff
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correct cuff length
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bladder nearly/completely circles arm (80%)
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what eye problems in htn pts?
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exudates
hemmorhage arteriolar narrowing cotton wool spots papilledema |
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heart problems in htn pts?
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Angina
MI |
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Kidney problems in htn pts?
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increase BUN and creatinine
nocturia |
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brain changes in htn pts?
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altered vision/speech
dizzy weak paralysis |
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labs for htn pts?
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urinalysis
Na and K Fasting glucose BUN/creat lipid ECG |
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maintain htn pts bp at what?
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140/90 or lower
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desired BP for diabetes or kidney disease pts?
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130/80 or lower
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what to consider when admin of antihypertensives for elders?
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give half starting dose than used for youth
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DASH diet used for htn?
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fruits/vegs
low in sat fat low in Na low fat dairy |
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men/women alcohol recommend per day?
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2 drinks
1 for women |
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what is considered one drink?
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1.5 fl oz of liquor
5 oz of wine 12 oz of beer |
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whats the 3 diuretics?
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loop
thiazide K sparing |
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action of thiazide?
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prohibit Na reabsorption in distal tubule
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is thiazide first line?
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yes
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why is thiazide safer?
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reduced risk for falls or dizziness
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why are thiazides good for elders?
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reduced bone breakdown in osteoporosis
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thiazide diuretics may produce what?
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hypokalemia
dehydration |
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what are 3 loop diuretics?
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lasix
bumex demadex |
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action of loop d's?
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volume depletion
inhibit Na reabsorption in Loop of H |
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eat what when taking L and T diuretics?
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K rich foods
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risks when taking Loop D's?
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blood clots
dizzy confusion insomnia increased falls CVAs |
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watch loop pts for what?
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postural hypotension
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K sparing meds?
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aldactone
midamor dyrenium |
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action of K sparing d's?
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inhibit na retained and effects of aldosterone
Bye Na and Keep K |
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potential for what failure during K sparing drugs?
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kidney
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side effects of k sparing d's
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ortho hypo
hyperkalemia dizzy ED |
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action of anti adrenergic meds?
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suppress stim of SNS and epinephrine
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action of non selective bb1
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block beta 1on cardiac
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action of non selective bb2
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block beta on smooth muscle of bronchi/vessels
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adverse effects of ns bb's
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bronchoconstriction
periph vasoconstriction glycogenolysis |
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dont give bb's to whom and what should we give them instead?
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pulmonary or diabetic pts
Give cardioselective bb's |
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cardioselective effect what
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b1
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action of alpha beta blocking agents?
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block alpha 1, beta 1, beta 2
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use what for htn emergencies?
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alpha beta blocking
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nursing action while giving bb's
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PULSE (under 50 for many days)
Edema? SOB? fatigue? dizzy |
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alpha2 adrenergic agents do what
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stim alpha 2 in CNS
inhibit norepinephrine in brain inhibit cardio acceleration and vasoconstriction |
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stimulated Alpha 2 receptors
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lower sympathetic output
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no norepi does..
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raises sympathetic stim throughout body
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adverse affects of A2AA
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depression
Rebound effect drowsy ED dry mouth bradycardia palpitate |
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action of A1AB
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dilate arteries and veins
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adverse effects for A1AB
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dizzy
HA weak palpitate Ortho Hypo ED |
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monitor what for pts with A1Ab?
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I&O
edema BP |
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Alpha 1 acts...
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peripherally
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Alpha 2 acts...
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centrally
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effects of ACE?
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vasodilation
reduce retention of Na and Water prevents remodeled heart |
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what does ACE do for heart?
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lower Stroke vol ratio with HR, CO or contract raised
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why use ACE for MI?
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prevent heart fail
prevents morbidity/mortality when added with ASA, bb, thrombo therapy |
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When use ACE for first line and why?
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diabetics bc reduce proteinuria and impairment of kidneys
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side effects for ACE
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cough
hypotension (start of therapy) angioedema |
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action of ARBS?
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prevent angiotensin 2 from binding to receptos in vessel walls
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effects of ARBS?
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vasodilate
reduced aldosterone |
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side effects to ARBs?
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dizzy
Hypotn GI HYPERkalemia tachycardia |
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action of CaChannel B?
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act on tissue of heart to prevent movement of ca into cell
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effect of CaCB?
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decrease HR
prevents vasospasms coronary/peripheral dilation slow cardiac conduction |
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side effects of CaCB?
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dizzy
faint irregular HR edema flushing constipate |
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when not to give CaCB?
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heart block
bradycardia HF hypotn |
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nurse imp when giving CaCB?
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BP/HR/I&O/edema
pulse under 50? change position slow |
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nitrates given....
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manage and prevent acute chest pain
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action of nitrate?
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dilate veins, arterioles, and coronary arteries
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common reaction for nitrates?
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HA
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htn urgency BP reads...
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DBP higher than 140
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htn emergency reads....
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BP greater than 180/120
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if a pt has HA, GI, seizures, confused, stupor, coma.. what might be wrong?
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organ dysfunction
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why dont reduce BP too fast in emergencies?
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organ hypoperfusion
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what causes about half of all htn crisis?
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med management in pts with prehtn
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