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18 Cards in this Set

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  • Back
WHAT IS EMERGENCY HTN?
RISK OF END ORGAN DAMAGE + LIFE THREATENTING; DAMANGE TO HEART, BRAIN, KIDNEY
WHAT IS URGENCY HTN?
NO RISK OF END ORGAN DAMAGE
ETIOLOGY OF HTN
WITH NO HX: ARF, ACUTE CNS EVENTS, AORTIC DISSECTION, PREG. INDUCTED ECLAMPSIA, PHEOCHROMOCYTOMA, DRUG INDUCED, DRUG-FOOD INDUCED; NONCOMPLIANCE WITH MEDS
PATHOPHYSIOLOGY OF HTN EMERGENCY...
HEART: CHEST PAIN, AHF, HTN p VASCULAR SURGERY
CNS: PAPILLEDEMA, HA, AGITATION, LETHARGY, CONFUSION, COMA, SEIZURE, FOCAL NEURO DEFICIT, ARF, CATECHOLAMINE EXCESS
ASSESSMENT AND DX OF HTN EMER.
BP MEASUREMENT IN BOTH ARMS, BP MONITORING WITH A-LINE, EKG TO FIND CAUSE
MEDICAL MANAGEMENT:

DEFINITION OF HTN EMERCENCY.
ACUTE BP ELEVATION OF >180/120 mmHG WITH IMPENDING OR ACTUAL TARGET ORGAN DAMAGE

ADMIT TO ICU, BP CONTINUOUSLY, IV ANTIHTN THERAPY, DONT LOWER BP TO QUICK
REASONS WHY NOT TO LOWER BP TO QUICK...
1. CAD: DECREASES CORONARY ARTERY FILLING
2. DECREASES BLOOD FLOW TO BRAIN (CPP)
3. RENAL ISCHEMIC POSSIBLITY
NIPRIDE USE
USUALLY FIRST LINE OF DRUG; NOT FOR RENAL PT
AORTIC DISSECTION MED
OLOL - LABETOLOL
HEART FAILURE MED
ACE INHIBITOR - ENALAPRILAT
ANGINA MED
VASODILATOR - NTG
RENAL PT MED
DOPAMINE RECEPTOR ANTAGONIST - FENOLDAPAM
CNS COMPROMISE MED
CA CHANNEL BLOCKER - NICARDIPINE
IF FLUID OVERLOAD MED
LASIX
NURSING MANAGEMENT OF HTN EMERGENCY
1. RETURN BP TO NORMAL VALUE W/O COMPLICATIONS OF THERAPY
2. ACUTE PHASE: ASSESS NEURO, CARDIAC, RENAL
3. MONITOR BP Q5MIN
NURSING MANAGEMENT OF HTN EMERCENCY
HOB 45 DEGREE UNLESS DECREASE BP

TRENDENLENBURG ASAP WHEN HTN CRISIS
RISK FACTORS MODIFICATION FOR HTN EMERGENCY.
1. FAT INTAKE <30% OF CALORIES
2. CHOLES <200MG/DL
3. SMOKING CESSATION
4. REDUCE SALT INTAKE
5. CONTROL BP (TAKE MED)
6. CONTROL DM
7. EXERCISE!!!!***
8. WGT REDUCTION OR MAINTENANCE
NURSING DX FOR HTN EMERGENCY
1. INEFFCTIVE CEREBRAL TISSUE PERFUSION R/T VASOSPASM OR HEMORRHAGE
2. INEFFECTIVE CARDIOPULMONARY TISSUE PERFUSION R/T ACUTE M.ISCHEMIA
3. ANXIETY...
4. DEFICIENT KNOWLEDGE...