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54 Cards in this Set

  • Front
  • Back
Primary hypertension is possible but unusual and it is usually secondary to another disease
Pediatric Hypertension
You begin taking blood pressure on children as a routine assessment starting at age ____
3
You always have to rule out __________ causes of hypertension in children
Secondary
If BP of a child is elevated, you need to take BP in the upper and lower _______
extremeties
If _________ of the aorta is present BP is low in lower extremeties
Coarctation
You check a ______ specimen to check protein, rbc and wbc
urine
You should always check _____ and do a renal sono if hypertension in child is present
Lipids
Management for primary hypertension is ________ loss and increased _________
Weight Loss
Increased Activity
If medications are neededyou should expect to give an _____ inhibitor, _____ blockers or diuretic
Ace Inhibitor
Beta Blocker
Symptoms of hypertension in children are ________ present
Rarely
______ parents to long term consequences is the key to success
Educating
Hypertension occurs most often in people between the age of _____ and ______ with risk increasing with age
25 and 55
Dx of hypertension in adults is with 2 BP on 2 different occasions of ____/____, or a single BP of more than _____/____
140/90
210/120
No identifiable cause for elevated BP which makes up 90% of all cases
Essential Hypertension
_______ hypertension is when a definable cause for BP elevation
Secondary
Normal BPis
less than 120/80
Prehypertension is
120-139/80-89
Stage 1 hypertension is
140-159/90-99
Stage 2 hypertension is
160-179/100-109
Stage 3 hypertension is
180-209/ 100-109
Stage 4 hypertension is
210+/120+
BP=____ output X peripheral vascular resistance
cardiac
Monitor arterial pressures respond to increased BP by causing vasodilation
Arterial Baroreceptors
Excess ______ cause an increase in BP
Fluid
When ______ function is normal the body senses the increase in BP and diuresis occur making the pressure fall
Kidney
Decreased blood flow to the kidney or decreased BP causes angiotension 1 to be released causin ___________ and increased BP
Vasoconstriction
________ receptors control vasoconstriction and pupil dilation
Alpha
This increases the heart rate and contractility and cause release of renin from the kidney
Beta-1
This is found in the lungs, arterioles, liver and uterus. It regulates bronchial diameter, arterial diameter and glycogenesis
Beta-2
Alpha recepters, Beta-1 and Beta-2 are adrenergic receptors and is stimulated by _______________
norepinephrine
This is associated with endothelial dysfunction and vessel wall thickening
Insulin Resistance
When insulin resistance is impared the ________ function is altered and angiotension II activity is increased
Renal
There are often ____ symptoms of hypertension
NO
Posterior headache which is present in the morning but resolving as the day progress, fatigue, confusion, nausea, vomiting and visual changes
Symptoms of hypertension
Persistant ________ or ___________ hypertension causes narrowing of arterioles, hemorrhage, exudates of retina and papilledema
Untreated or uncontrolled
These are _________ changes in Hypertension:
Left ventricular hypertrophy
Renal Insufficiency
TIA or stroke
MI
CHF
Aortic dissection
Perpherial Artery Disease
Sudden death
Changes to the eye
Physical
When getting a history you need to get:
____ HX
Social Habits
Medication
Exercise Habits
Family
If you have hypertension you should have an _____ _____ done at every visit
Eye Exam
You also need to do an ________ assessment, check heart sounds, BP and check extremeties for edema
Arterial
EKG
Renal Function
Chlorestoral Check
UA
Chest Xray, ct mri
Labs and diagnostic testing
Regular monitoring and recognition of elevated BP reading, ________ modifications and medication
Lifestyle
When doing a nursing assessment to get hx you do:
Asses for presence of S&S of hypertension
BP measurements
________ assessment
Pulses
UA
Annual eye exam
Cardiac
You need to ______ your patient how to live with their disease, and how to understand it is the single mos important thing you can do for them
Teach
You need to teach the patients:
___ _____ of medications
Take meds regulary
Lifestyle changes
Warning signs and symptoms
When to call MD or 911
BP monitoring at home
Involve other family members
Side effects
BP >200/>150
Malignant hypertension
Caused by sudden cessation of meds, renal disease or in someone with poorly controlled HTN
Malignant Hypertension
Treatment for malignant hypertension must be rapid to avoid _____ damage or death
organ
Fast acting meds for malignant hypertension are
Nitropursside
Treatment goal for malignant hypertension is to reduce BP by no more than _____ the first minutes to 2 hours.
The BP needs to be down to 160/100 over 2-6 hours
25%
BP should be monitored every ___ to ____ minutes
5-30
In someone with malignant hypertension you always need to monitor _____ to assess for end organ damage.
labs
this leads too:
IRREVERSIBLE RENAL AND OR CARDIAC FAILURE
Encephalopathy
headache
dizziness
confusion
visual changes
papiledema
untreated hypertension
If a patient is hospitalized with hypertension you need to take vitals every 4 hours, _____ and especially DAILY ______ because that is the best indicator of increased fluid retention, meaning decreased cardiac function and renal perfussion
I&O's
Weights
These are the labs you should monitor
BUN
creatinine
electrolytes
urine specific gravity
H&H