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CARDIAC OUTPUT

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...a measure of the pumping ability of the heart; AMOUNT OF BLOOD PUMPED BY THE HEART PER MINUTE

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DIASTOLIC B/P

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THE AMOUNT OF PRESSURE EXERTED ON THE WALL OF THE ARTERIES WHEN THE VENTRICLES ARE AT REST. THIS IS THE BOTTOM NUMBER IN A B/P READING...

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ESSENTIAL HYPERTENSION

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CHRONIC ELEVATION OF B/P RESULTING FROM AN UNKNOWN CAUSE...

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HYPERTENSION

answer

ABNORMALLY ELEVATED B/P...

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HYPERTENSIVE EMERGENCY

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SYSTOLIC B/P ABOVE 180 mmHg AND DIASTOLIC B/P ABOVE 120-130 mmHG...; NIFRIDE USED WITH THIS; CLOSELY MONITOR P/T WITH THIS;

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HYPERTENSIVE URGENCY

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SYSTOLIC B/P ABOVE 180 mmHg AND DIASTOLIC PRESSURE ABOVE 120-130 mmHg.. USE NITRO WITH THIS.

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HYPERTROPHY

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AN INCREASE IN THE SIZE OF AN ORGAN OR STRUCTURE OR OF THE BODY OWING TO GROWTH RATHER THAN TUMOR FORMATION...

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ISOLATED SYSTOLIC HYPERTENSION

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THE SYSTOLIC PRESSURE IS 160 mmHg OR MORE BUT THE DIASTOLIC PRESSURE IS LOWER THAN 95 mmHg.. THIS TYPE OF HYPERTENSION MAINLY OCCURS IN THE ELDERLY.

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NORMOTENSIVE

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...NORMAL B/P

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PERIPHERAL VASCULAR RESISTANCE

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OPPOSITION TO BLOOD FLOW THROUGH THE VESSELS...

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PLAQUE

answer

A DEPOSIT OF FATTY MATERIAL ON THE LINING OF AN ARTERY

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PRIMARY HYPERTENSION

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ABNORMALITY OF ELEVATED B/P OF UNKNOWN CAUSE. ALSO CALLED ESSENTIAL HYPERTENSION.

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SECONDARY HYPERTENSION

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HIGH BLOOD PRESSURE THAT IS A SYMPTOM OF A SPECIFIC CAUSE, SUCH AS A KIDNEY ABNORMALITY

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SYSTOLIC BLOOD PRESSURE

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MAXIMAL PRESSURE EXERTED ON THE ARTERIES DURING CONTRACTION OF THE LEFT VENTRICLE OF THE HEART. THE TOP NUMBER OF A BLOOD PRESSURE READING.

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VISCOSITY

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THICKNESS AS OF THE BLOOD

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PATHOPHYSIOLOGY OF HYPERTENSION

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DECREASED STRETCHING ABILITY OF BLOOD VESSELS INCREASED BLOOD VISCOSITY AND OR INCREASED FLUID VOLUME MAY INCREASE BLOOD PRESSURE

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CAUSES AND RISK FACTORS OF HYPERTENSION

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NERVOUS SYST. REGULATION; ARTERIAL BARORECEPTORS AND CHEMORECEPTORS, THE RENIN- ANGIOTENSIN- ALDOSTERONE MECH. AND THE BAL. OF BODY FLUIDS. SYMPATH. NERV. SYST. OVERSTIM. CAUSES VASOCONSTR. ALTERATIONS IN BARORECEPT. AND CHEMORECEPT. INCR. IN HORMONES. CHANGES IN KIDNEY FUNCT. STUDIES HAVE SHOWN THAT CYTOMEGALOVIRUS IS A FACT. ALSO. A COMBO OF GENETIC AND ENVIRON. RISK FACTORS IS THOUGHT TO BE RESPONSIBLE FOR DEV. OF HYPERTENSION. NON MOD. RISKS- HEREDITY, AGE, ETHNICITY,DIABETES MELLITUS. MODIFIABLE RISKS- BLOOD GLUCOSE,, ACTIVITY LEVELS, SMOKING, SALT AND ALCOHOL INTAKE, IMPROVED DIET,SUFFICIENT SLEEP HABITS, REDUCED CAFFEINE INTAKE AND MANAGING STRESS. OBESITY

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SIGNS AND SYMPTOMS OF HYPERTENSION

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OFTEN HYPERTENSION HAS NO S/S OTHER THAN ELEVATED READING. IT IS OFTEN REFERRED TO AS A SILENT KILLER. P/T MAY REPORT A HEADACHE, BLOODY NOSE, SEVERE ANXIETY, OR SHORTNESS OF BREATH.

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CURRENT THERAPEUTIC MEASURES USED FOR HYPERTENSION

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WHEN AV. SEATED B/P IS ABOVE PREHYPERTENSIVE LEVELS OF 120-139 SYSTOLIC OR 80-89 DIASTOLIC ON 2 OR MORE OCCASIONS THEN HYPERTENSION IS DIAGNOSED. THE JOINT NURSING COMMISSION 7 PROVIDES GUIDELINES FOR SELECTING THERAPY BASED ON THE P/T 'S B/P BASED ON RISK FACTORS AND THE PRESENCE OF TARGET-ORGAN DISEASEOR CARDIOVASCULAR DISEASE. ALL THERAPY BEGINS W/LIFESTYLE MODIFICATIONS. IF MODIFICATIONS DONT WORK TIER SYSTEM BEGINS. TIER 1- THIAZIDE AND THIAZIDE- LIKE DIURETICS ORDERED IF GOAL NOT REACHED TIER 2 MEDS ADDED TO CONCOCTION. TIER 2 MEDS ARE SYMPATHOLYTICS OR BETA BLOCKERS. IF GOAL IS NOT MET THEN GO TO TIER 3 AND ADD ALPHA BLOCKERS TO THE BETA BLOCKERS AND THE DIURETICS. IF B/P GOAL IS NOT MET GO TO COMBINED ANGIOTENSIN-CONVERTING ENZYME ACE INHIBITORS. IF B/P GOAL IS NOT MET AN ANGIOTENSIN II RECEPTOR ANTAGONIST IS ADDED TO THE MIX. THEN ALDOSTERONE RECEPTOR ANTAGONIST ARE ADDED IF FURTHER THERAPY IS NEEDED.. ONE OF THE LAST RESORTS IS A CALCIUM CHANNEL BLOCKER. THE LAST RESORT IS A DIRECT VASODILATOR.

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WHAT ARE THE CLASSIFICATIONS OF HYPERTENSION IN ADULTS AND RECOMMENDATIONS FOR TREATMENT?

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PREHYPERTENSION- 120/80-139/89 -FOLLOWUP IN 1 YEAR; ENCOURAGE LIFESTYLE MODIFICATION STAGE 1 HYPERTENSION140/90- 159/99- FOLLOWUP 2 MONTHS-ENCOURAGE LIFESTYLE MODIFICATION AND THIAZ. COMBO. CONSIDER ACE INHIB. ANG.II REC. ANTAG.,BETA BLKERS, OR COMBO STAGE 2 HYPERTENSION 160/100-UP-TWO DRUG COMBO USUALLY THIAZIDE DI. AND ACE I OR ARB,BB,OR CCB

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WHAT ARE COMMON COMPLICATIONS OF HYPERTENSION?

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COMMON COMPLICATIONS OF HYPERTENSION ARE CAD, ATHERIOSCLEROSIS MI, HF, STROKE KIDNEY OR EYE DAMAGE. HYPERTENSION MAY CAUSE THE LT. VENT. TO HYPERTROPHY.

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HOW WOULD YOU CLASSIFY A HYPERTENSIVE EMERGENCY?

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HYPERTENSIVE EMERGENCY IS A SEVERE TYPE OF HYPERTENSION CHAR. BY ELEV. GREATER THAN 180mmHG SYSTOLIC AND DIASTOLIC B/P GREATER THAN 120 mmHg.P/T ARE COMPLICATED VY A RISK FOR OR PROGRESSION OF TARGET ORGAN DYSFUNCTION EX INCL MI, HF, AND DISSECT. AORTIC ANEURYSM GIVE NIFRIDE FOR THIS. B/P NEEDS TO BE REDUCED WITHIN 1 HR TO PREVENT TARGET ORG. DAMAGE. SHOULD BE ADMITTED TO CCU FOR THIS

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WHAT NURSING CARE WILL YOU PROVIDE FOR P/T WITH HYPERTENSION?

answer

DATA COL. FOR A P/T WITH HYPERTENSION INCL. P/T HEALTH HIST. B/P, MEDS., PHYS ASSESSMENT. INFORMING THE FAMILY ABT P/T COND. AND RISKS IS ESSENT. FOR P/T AND FAM. ED. AND MODIF. NEEDS.

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HOW WILL YOU KNOW IF YOUR NURSING INTERVENTIONS HAVE BEEN EFFECTIVE?

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YOU WILL KNOW IF INTERVENTIONS WERE EFFECTIVE BY EVALUATION . IS THE PATIENT MEETING THE GOAL.

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WHAT IS A CAUSE OF PRIMARY HYPERTENSION

answer

THE CAUSE IS UNKNOWN

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WHAT IS THE MOST IMPT. LIFESTYLE MOD. FOR THE HYPERTENSIVE P/T WHO IS OBESE?

answer

WEIGHT REDUCTION

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WHAT DOES THE NURSE UNDERSTAND IS OFTEN THE ONLY SIGN OF HYPERTENSION?

answer

ELEVATED B/P

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WHAT INSTRUCTIONS SHOULD BE INCLUDED IN DIETARY ED FOR A P/T W/ HIGH B/P?

answer

CHOOSE FRESH OR FROZEN FRUITS AND VEGGIES READ FOOD LABELS WATCH FOR POTASSIUM IN SALT SUBSTITUTES

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AT WHAT B/P READING WOULD A 1-YR FOLLOW-UP VISIT BE RECOMMENDED

answer

138/84mmHg

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DURING EXAMINATION, A P/T B/P IS CONFIRMED BY 2 NURSES TO BE 210/120 mmHg. WHAT INTERVENTION WOULD BE RECOMMENDED?

answer

THE PATIENT SHOULD REST QUIETLY WHILE THE NURSE CALLS 911 TO REQUEST AN AMBULANCE

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WHAT WOULD THE NURSE EXPECT TO FIND IN A P/T EXPER. THE COMP. OF HT. FAILURE FROM HYPERTENSION?

answer

DISTENDED JUGULAR VEINS; IN SEMI-FOWLERS POSITION

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THE NURSE SHOULD ADVISE A P/T TO DO WHAT WHEN RECEIVING A DIURETIC

answer

CHANGE POSITIONS SLOWLY

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AT A FOLLOW UP VISIT FOR A P/T WITH HYPERTENSION WHAT DATA BEST IND. THAT THE P/T B/P THERAPY HAS BEEN SUCCESSFUL?

answer

B/P IS LESS THAN 120/80 mmHg

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NORMAL B/P

answer

ANY B/P LESS THAN 120/80; RECOMMENDED FOLLOWUP 2 YRS. ENCOURAGE LIFESTYLE MOD; NO DRUG THERAPY

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PREHYPERTENSION

answer

A B/P OF 120/80-139/89 mmHg; RECOMMENDED FOLOWUP 1YR; ENCOURAGE LIFEST. MOD.; NO DRUG THERAPY

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STAGE 1 HYPERTENSION

answer

140/90-159/99 mmHg; RECOMMENDED FOLLOWUP 2 MONTHS; LIFESTYLE MODIFICATION; THIAZIDE-TYPE DIURETICS PRESCRIBED; CONSIDER ACE I OR ARB, BB, OR CCB OR COMBINATION.

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STAGE 2 HYPERTENSION

answer

160/100 OR HIGHER; RECOMMENDED FOLLOWUP 1 MONTH; FOR B/P OVER 180/110mmHg, EVAL. AND SEEK TREATMENT IMMEDIATELY; THEN 1WK AS NEEDED; LIFESTYLE MOD IS IND.; 2-DRUG COMBO (USUALLY THIAZIDE-TYPE DIURETIC AND ACE I OR ARB, BB, OR CCB)

question

HYPERTENSION

answer

HIGH B/P IS A CONDITION IN WHICH THE AVERAGE OF AT LEAST 2 OR MORE READINGS ON DIFFERENT DATES WITH IN 1 MONTH IS ABOVE PREHYPERTENSION.

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TAKING ACCURATE B/P MEASUREMENTS

answer

AUSCULT. METH.; SEAT P/T FOR 5 MIN. IN CHAIR W/FEET ON FLOOR AND ARM SUPP. @ HEART LEVEL; USE APPROP. SIZED CUFF- BLADDER MUST ENCIRCLE 80% OF ARM; TAKE 2 B/P MEASUREMT.; SYST. B/P= 1ST OF 2 OR MORE SOUNDS HEARD. DIAST. B/P= DIS. OF SOUNDS; PROV. P/T VERBALLY & IN WRITING THEIR B/P READING

question

SAFETY TIP

answer

STUDIES SHOW THAT STETH. USED BY ALL TYPES OF HEALTH PROV. ARE CONTAM. W/ BACTERIA INCL. MRSA

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BEST WAY TO DECONTAMINATE STETH.

answer

CLEAN STETH W/ ISO. ALCOH. OR EBC.

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HOW IS B/P DET.

answer

B/P IS DETERMINED BY CARD. OUTPUT (CO), PERIPHERAL VASCULAR RESISTANCE (PVR: THE ABILITY OF THE VESSELS TO STRETCH); THE VISCOSITY (THICKNESS) OF THE BLOOD AND THE AMT. OF CIRC. BLOOD VOL.DECREASED STRETCHING ABILITY OF THE BLOOD VESSELS, INCR. BLOOD VISCOSITY, AND/OR INCR. FLUID VOL. MAY INCR. BLOOD PRESSURE

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WHAT PROC. MAY INFLU. B/P

answer

THESE PROC.MAY INCL. NERV. SYST. REG., ARTERIAL BARORECEPTORS, AND CHEMORECEPTORS, THE RENIN-ANGIOTENSIN-ALDOSTERONE MECH., AND THE BAL. OF BODY FLUIDS. ADJUSTMENT OF CARD. OUTPUT INFLU. B/P WHICH EFFECTS B/P- THE HEART RESPONDS TO EMOTIONAL ACT. THAT INCR. THE NEED FOR OXYGEN IN TISSUES; PVR- PERIPH. VASC. RES.- THE OPPOS. THAT BLOOD ENCOUNTERS AS IT FLOWS THROUGH VESSELS.

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WHEN IS HYPERTENSION DIAG.

answer

WHEN THE AVERAGE SEATED B/P IS ABOVE PREHYPER. LEVELS OF 120-139 SYS. AND 80-89 DIAST. ON 2 OR MORE OCCASIONS THEN HYPERTENSION IS DIAG.

question

WHAT ARE RISK FACTORS FOR HYPERTENSION

answer

A COMBO OF GENETIC (NONMOD.) AND ENV. (MOD.) RISK FACTORS ARE THOUGHT TO BE RESP. FOR DEV. OF HYPERTENSION. NONMOD.- FAM. HIST., AGE, ETHNICITY, AND DIABETES MELLITUS; MODIF.- INCL. BLOOD GLUC. LEVEL, ACT. LEVEL, SMOKING, SALT AND ALCOHOL INTAKE, AND NEWLY ADDED INSUFF. SLEEP, CAFFEINE INTAKE,W/T REDUCTION

question

AFTER DIAG. OF 1 MO. OF HYPERTENSION

answer

THE LOW OR NO RISK HYPERTENSIVE P/T THERAPY BEG. WITH LIFESTYLE MOD. IF MOD. ALONE DO NOT HELP THEN DRUG THERAPY IS REC. ESP. W/ TARG. ORG DIS.

question

IF RESP IS INADEQUATE TO ACH. B/P GOAL WHAT NEXT

answer

IF RESP. IS INAD. TO ACH. B/P GOAL, THE DOSAGE MAY BE INCR. OR A 2ND DRUG FROM A DIFFERENT CLASS ADDED. USUALLY 2 AND SOMETIMES 3 OR 4 MEDS FOR RESISTANT HYPERTENS. ARE ADDED. COMBO FORMS OF MEDS ARE AVAIL.

question

MEDS TO TREAT HYPERTENSION

answer

1ST TIER- DIURETICS (THIAZIDE/THIAZIDE-LIKE DIURETICS) 2ND TIER- BETA BLOCKERS, ALPHA BLOCKERS, COMBO ALPHA AND BETA BLOCKERS 3RD TIER- ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS ANGIOTENSIN II RECEPTOR ANTAGONISTS (ARB) ALDOSTERONE RECEPTOR ANTAGONIST 4TH TIER- CALCIUM CHANNEL BLOCKERS 5TH TIER- DIRECT VASODILATORS

question

COMPLICATIONS OF HYPERTENSION

answer

COMMON COMPLICATIONS OF HYPERTENSION INCLUDE COR. ART. DIS. ATHERIOSCLEROSIS, MYOCARDIAL INFART. (MI), AND HEART FAILURE, KIDNEY ,STROKE, AND EYE DAMAGE

question

HIGH B/P LEVELS MAY INCREASE THE SIZE OF WHAT PART OF THE HEART

answer

THE L/T VENTRICLE

question

ATHEROSCLEROSIS

answer

THE MOST COMMON FORM OF ARTERIOSCLEROSIS, IN WHICH FATS ARE DEPOSITED ON THE WALLS OF ARTERIES

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PERIPERAL VASCULAR RESISTANCE

answer

OPPOSITION TO BLOOD FLOW THROUGH THE VESSELS

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ISOLATED SYSTOLIC HYPERTENSION

answer

SYSTOLIC PRESSUE IS 140 mmHg OR MORE, BUT THE DIASTOLIC PRESSURE IS LESS THAN 90 mmHg

question

DIASTOLIC BLOOD PRESSURE

answer

AMT. OF PRESSURE EXERTED ON THE WALL OF THE ARTERIES WHEN THE VENTRICLES ARE AT REST; THE BOTTOM NUMBER IN A B/P READING

question

CARD. OUTPUT

answer

THE AMT OF BLOOD THE HEART PUMPS OUT EA. MIN.

question

SYST. B/P

answer

MAX. PRESSURE EXERTED ON THE ARTERIES DURING CONTRACTION ON THE LT. VENTRICLE OF THE HEART; TOP NUMBER OF A B/P READING

question

SEC. HYPERTENSION

answer

HIGH B/P THAT IS A SYMPT. OF A SPEC. CAUSE, SUCH AS A KIDNEY ABNORM.

question

PRIMARY HYPERTENSION

answer

ABNORM. ELEVATED B/P THE CAUSE UNKNOWN; ALSO ESSENT. HYPERTENSION

question

PLAQUE

answer

DEPOSIT OF FATTY MATERIAL IN THE ARTERY

question

SPIRONOLACTONE (ALDACTONE)

answer

POT. SPARING MED

question

BUMETANIDE (BUMEX)

answer

LOOP MED.

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CHLOROTHIAZIDE (DIURIL)

answer

THIAZIDE/ THIAZIDE-LIKE MED

question

TRIAMTERENE (DYRENIUM)

answer

POTASSIUM SPARING MED

question

FUROSEMIDE (LASIX)

answer

LOOP MED

question

AMILORIDE (MIDAMOR)

answer

POTASSIUM SPARING MED

question

METOLAZONE (ZAROXOLYN)

answer

THIAZIDE OR THIAZIDE-LIKE MED

question

HYDROCHLOROTHIAZIDE (HYDRODIURIL, HCTZ)

answer

THIAZIDE OR THIAZIDE-LIKE MED

question

TORSEMIDE (DEMADEX)

answer

LOOP MED

question

IF THE SYSTOLIC B/P IS ELEV. AND THE DIASTOLIC B/P IS NORM., THE NURSE RECOG. THAT A P/T HAS

answer

ISOLATED SYSTOLIC HYPERTENSION

question

THE NURSE UNDERSTANDS THAT A P/T W/A B/P W/READINGS OF 164/102 mmHg AND 176/100 mmHg ON 2 SEPARATE OCCASIONS WOULD BE CLASSIFIED IN WHICH CATEGORY

answer

STAGE 2 HYPERTENSION

question

THE NURSE UNDERSTANDS THAT WHICH OF THE FOLLOWING BEST DESCRIBES THE ACTION OF ENALAPRIL MALEATE (VAOTEC)

answer

IT DECREASES LEVELS OF ANGIOTENSIN II

question

THE NURSE UNDERSTANDS THAT WHICH OF THE FOLLOWING BEST DESCRIBES THE ACTION OF PROPANOLOL (INDERAL)

answer

IT DECREASES CARDIAC OUTPUT

question

THE NURSE IS DEV. A TEACHING PLAN FOR A P/T WHAT ARE MOD. RISK FACTORS FOR THE DEVELOPMENT OF HYPERTENSION

answer

HIGH CHOLESTEROL CIGARETTE SMOKING SEDENTARY LIFESTYLE LESS THAN 5 HRS. OF SLEEP

question

THE P/T ASKS THE NURSE, " HOW IS HYPERTENSION DEFINED?"

answer

IT IS B/P ABOVE 140/90 mmHg ON 2 SEPARATE OCCASIONS

question

WHAT INFO SHOULD THE NURSE INCLUDE WHEN COUNSELING A PATIENT ABOUT SMOKING AND ITS EFFECT ON B/P

answer

SMOKING IS ASSOCIATED W/STAGES 1&2 HYPERTENSION

question

A P/T CALLS THE HYPERTENSION CLINIC TO REPT. FREQ. HEADACHES W/A NEWLY PRESCRIBED MED. THE NURSE ANTIC. THAT THIS IS A NORMAL; SIDE EFFECT IF THE PAT. IS TAKING WHICH OF THE FOLLOWING MED..

answer

ADALAT( PROCARDIA)

question

A P/T HAD BEEN PRESCRIBED BUMETANIDE (BUMEX) EVERY MORINING FOR CONTROL OF HYPERTENSION. WHICH OF THE FOLLOWING STATEMENTS IND. CORRECT KNOWLEDGE OF THE TREATMENT REG.

answer

I'LL TAKE MY MED.IN THE MORNING, EV. MORNING

question

WHAT IS A COMMON SIDE EFFECT OF METOLAZONE (ZAROLYN) TO BE REPT.

answer

MUSCLE WEAKNESS

question

SIDE EFFECT OF ENALAPRIL MALEATE (VASOTEC) REPT. TO NURSE

answer

COUGH

question

INSTRUCTIONS FOR . NURSE TO GIVE P/T TAKING PROPROPANOL (INDERAL)

answer

DO NOT STOP TAKING ABRUPTLY

question

APPROP. NURSING DIAG. FOR CARE FOCUS W/A P/T W/ HYPERTENSION

answer

DEFICIENT KNOWLEDGE

NURSING CARE OF PATIENTS WITH HYPERTENSION CHAPTER 22 MED/SURG – Flashcards

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