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18 Cards in this Set
- Front
- Back
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T or F: Middle aged men have a higher % on hypertensive cases than middle aged women.
Is their an age bracket where the reverse is true? |
T
Yes, elderly women have a great % of hypertension than elderly men. |
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Which sex and race have the greatest degree of morbidity adn mortality when it comes to HTN/CAD?
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Men and African-Americans have greater morbidity and mortality. Mortality due to CAD
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Fill in the blank:
Each increment of ____ mmHg in systolic BP or ____ mmHg in diastolic BP doubles the risk of CVD |
20; 10
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Why do we treat HTN, what is the main goal?
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To prevent organ damage and death.
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What is the bp goal for a average hypertensive patient?
What is the bp goal for a diabetic or patient with renal disease? |
140/90
130/80-diabetic |
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Why do diabetics have that increases their bp?
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SUGAR! When sugar goes up, because it’s a solute, what follows it?- Water!
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What is the prehypertension bp?-Stage I?; Stage II?
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Pre: 120-139/80-90 mmHg
Stage I: 140-160/90-99 Stage II: > 160/>100 |
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When performing the patient eval, what are the objectives of evaluation?
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-Assess lifestyle and identify cardiovascular risk factors or concomitant disorders that may affect prognosis and guide treatment
-Reveal identifiable causes of high BP -Assess the presence or absence of target organ damage and CVD |
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When performing the PE, what are the major areas to "key in on"?
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Check bp; fundi; thyroid; heart & lungs; bruits (caused by atheroma hanging in lumen and disrupting blood flow) in carotids, renal, and iliac arteries; diminished pulses in and edema in extremities
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When treating a HTN patient, what are some lab tests that can assist assessing patients' organ damage/risk factors?
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Hematocrit: determines viscocity of blood- increased viscosity= increased sugar/stickiness
UA: serum protein Electrolytes/EKG: cardiac arrhythmias Lipid panel: determines risk with high or low lipid levels |
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What are the areas that lifestyle modifications can be made?
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Sodium intake, sat. fat intake, physical activity, weight loss, alcohol reduction
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What are the drugs for monotherapy?
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Drugs for monotherapy: Diuretics, β-blockers, Calcium channel antagonists, ACE inhibitors, α-β-blockers, and angiotensin II receptor blockers (ARBs)
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Hypertensive emergencies can ensue after a patient stops...
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Taking their bp meds.
Hypertensive Emergency (can be called Malignant HTN): patient has essential hypertension, stop taking meds, develop renal vascular disease and then bp skyrockets. hypertensive encephalopathy. Brain is not getting blood supply like it should. Brain usually self regulates due to autoregulation. Brain ususally constricts but can only do for so long. After constriction, get dilation- patient can show neural deficits (coma, seizure, huge optic disc, severe headache, papuledema- disc starts to cut blood supply off. Bring bp down quickly. 180/110 is an example of a hypertensive emergency |
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Do we want to bring bp down slowly or quickly in hypertensive emergency? -in hypertensive urgency?
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Hypertensive emergency-bring bp down quickly.
Hypertension Urgency- bring it down slowly. May or may not have to admit them. Can manage w/ oral meds usually. Not seeing patient symptoms as above. |
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What are the symptom differences between hypertensive emergency and hypertensive urgency?
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Emergency- vision problems, headache, confusion, coma, seizures.
Urgency- not seeing the severity of symptoms as in emergency |
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What are some causes of hypertensive emergencies or urgencies?
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Neglected essential HTN, sudden discontinuation of medications (especially clonidine and β-blockers), renovascular disease, intracerebral hemorrhage or subarachnoid hemorrhage, pheochromocytoma crisis.
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In terms of managing a hypertensive emergency or urgency, what is the bp goal and what meds are we going to use to get there?
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Goal: bring diastolic down to 110 then slowly to 90-100.
Meds: NTG and/or sodium nitroprusside. Can have toxicity develop from sodium nitroprusside so need Sodium Nitrite or hydroxocobalamine for toxicity symptoms. |
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What is the definition of resistant hypertension?
What do we do with this type of patient? |
Failure to reach goal BP in patients who are adhering to full doses of an appropriate three-drug regimen that includes a diuretic.
Refer to a HTN specialist. |
