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25 Cards in this Set
- Front
- Back
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aldosterone
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retains sodium and water
so -->Na & H20 retention = increase in BP |
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HTN Classification
Normal Prehypertensive |
Systolic BP Diastolic BP
< 120 < 80 120-139/ 80-89 |
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Stage 1 HTN
Stage 2 HTN |
Systolic BP Diastolic BP
140-159/ 90-99 >160 >100 |
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These are the 1st signs if kidney’s are not functioning properly
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-protein or albumen in urine?
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Echocardiogram
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looking at walls of heart and their functioning and if over time HTN has caused pressures on the heart that have weakened the walls and end up w/ CHF
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Fundoscopic Exam-
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examining back of eye and retina for damage HTN has done over time
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sodium limited to
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2.4 g/day
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with aging
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SBP tend to get higher while DBP dose not
Isolated systolic HTN -w/ aging, SBP better indicator than DBP of risk for heart disease & stroke |
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Hypertensive Crisis
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-severe high BP, ICU, target organ damage, severe HA, dizziness, blurred vision, SOB, urema
-organs will start shutting down -ICU…receive anti-HTN -Quick vasoldilators to ↓BP…when BP is stabilized…switched to oral anti-HTN's |
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Malignant HTN
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-severe, rapidly progressive
-s/s: morning HA, blurred vision, dyspnea uremia -30-50 yrs -SBP > 200, DBP > 150 OR > 130 pre-existing compl -Untreated: renal failure, L ventricular failure, stroke |
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Meds for htn crisis
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oNitroprusside (Nipride)
oNicardipine (Cardene IV) oFenoldopam (Corlopam) oLabetalol (Normodyne) |
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htn crisis interventions
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-Semi-Fowler’s position -Oxygen
-Start IV of 0.9% NS-monitor b/c too much fluid will cause ↑BP -Administer IV antihypertensives -Monitor BP-q5-15min until DBP is below 90, but not less than 75; then monitor q30min so BP not lowered too quickly -Observe for complications-neuro and cardiovascular: seizures, numbness, tingling of extremities, palpitations, chest pain, dysrhythmias. These are signs of target organ damage. Progress 25/26 |
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Low density Lipoprotein (LDL)
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1. have highest concentration of cholesterol
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High density lipoprotein (HDL)
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1. have lowest concentration of cholesterol
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Ratio of HDL to LDL
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1. people with high levels of HDL in proportion to LDL are less likely to develop coronary artery
disease than people with low HDL. 2. HDL levels are raised through exercise and low fat, low cholesterol diet. |
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***Drug Therapy in Hyperlipidemia Indication***
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The 2004 updated National Cholesterol Education Program (NCEP) guidelines recommend that all patients with LDL cholesterol levels:
-exceeding 190 mg/dL and -those with LDL levels between 160 & 190mg/dL who have CHD or two or more risk factors for heart disease be considered for drug therapy after an adequate trial of dietary and other nondrug therapies has proved ineffective for 6 months. |
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**The updated guidelines even recommend optional use of drug therapy**
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to reduce LDL to less than 70 mg/dL in patients at
very high risk and to less than 100 mg/dL in patients at moderately high risk. |
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**“Very high risk” patients include**
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-those with active cardiovascular disease with other major risk factors such as diabetes, continued smoking, or metabolic syndrome.
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**“Moderately high risk” patients include those**
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without cardiovascular disease but with two or more risk factors. Identifying Features of the Metabolic Syndrome
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**-->Metabolic syndrome**
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is a set of risk factors associated with obesity, including hyypertriglyceridemia and low HDL level.
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**Identifying Features of the Metabolic Syndrome**
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Waist circumference >40 in in men or >30 in women
-Serum triglyceride level of 150 mg/dL or more -High-density lipoprotein cholesterol level of <40 mg/dL in men or <50 mg/dL in women -Blood pressure of 130/85 mm Hg or higher -Fasting serum glucose level higher than 110 mg/dL |
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**Drug Therapy Hyperlipidemia Four classes plus**
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. hydroxymethylglutaryl–coenzyme A (HMG–CoA) reductase inhibitors **(statins)** was highlighted!*
2. bile acid sequestrants 3. B vitamin niacin (vitamin B3, aka nicotinic acid) 4. fibric acid derivatives (fibrates). 5. new drug ezetimibe (Zetia) is now available that is a cholesterol absorption inhibitor. |
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*******************************************
*what is a more common on side effect of statins?* -Lovastatin (Mevacor) -simvastatin (Zocor) |
myopathy/rhabdomyolysis/increased creatinine kinase
muscle skeletal issues |
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Risk factors for myopathy symptoms:
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older than 65 years
-hypothyroidism, renal insufficiency -concurrent use of the immunosuppressant drug cyclosporine or the antihyperlipidemic drug gemfibrozil |
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what are the s/s of myopathy
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-muscle soreness, changes in urine color, fever, malaise, nausea, or vomiting.
-pt should be educated re: these serious, although uncommon, adverse drug effects & instructed to immediately report any signs of toxicity |
