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39 Cards in this Set
- Front
- Back
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Cardiac output
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the volum that the heart (blood/fluid) is ejecting (from the left ventricle).
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SVR=Systemic Vascular Resistance
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resistance in the vessels
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The SNS (sympathetic Nervous System) influence blood pressure how?
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SNS produces adreline and epinepherine which causes tachycardia and vasoconstriction
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How does the renal system influence blood pressure?
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Na and H2O are excreted through the kidneys, if they are not working correctly and are holding the volume it can increase the BP. Also, angiotension I and II are powerful vasoconstrictors that are released by the kidney.
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The endocrine system influences blood pressure how?
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hormonal release of aldestrone also lined with Na and H2O excretion if impaired renin will increase and contribute to HTN
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Primary hypertension
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no known cause
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Secondary hypertension
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a known underlying factor such as renal disease, endocrine disorders, head injury and some medications.
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Non-modifable risk factors for HTN are
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age, gender, race, family history
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Modifable risk factors for HTN are
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smoking, obesity, sodium intake, lipid levels, alcohol consumption, sedentary lifestyle, stress, diabetes
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True/False-most people often have a headache as a symptom of HTN
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False, though some do have headaches, most people are unaware that they have HTN, that is why it is known as the "silent killer"
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What are the clinical manifestations (when present) of HTN?
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headache, dizziness, angina, blurred vision, epistaxis
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What type of obesity is known to increase your risk of HTN
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Centeral abdominal obesity ("apple" body shape).
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HTN is 2X's more common in which racial/gender group
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African American Males
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If you have a first degree relative (mother, father) that has HTN you are ___X's more likely to have HTN
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2 times more likley
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Renal effects of HTN
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renal arteries narrow and blood and O2 are not getting to it. The ischemic and necrotic results in the kidneys failing.
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Peripheral vascular effects of HTN
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the ischemic changes to the lower extremitis cause pain and necrosis
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Cardiac effects of HTN
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the left ventricle works harder to pump the blood, however, the heart will get thicker, dilate and flabby and hypertrophy occures, the heart can't pump and CHF is a consequence.
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Cerebral effects of HTN
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pressure on vessels increase and can rupture causing stroke
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Retinal effects of HTN
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hemmorages or vascular changes in the retina (that is why many people are found to have HTN during eye exams)
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Treatments of HTN
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Dietary, exercise, cessation of smoking and stress mgt. Meds are added after these measure fail on their own
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People who have HTN and are on a low salt diet should avoid?
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processed foods, fried foods, canned goods, boxed foods, cold cuts, cheese, some frozen foods, whole milk and fast foods
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People on a low salt HTN diet should eat?
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grilled chicken, fresh fruits and vegetables, fish, olive oil and whole grains
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Loop diuretics decrease sodium reabsorption in the loop of henle, promotes K+ excretion-what meds and nursing int.
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Lasix is the most common (IV or PO) and you should monitor BP, I&O, K levels and watch for dehydration (esp. in elderly).
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Thiazide diuretics prevents sodium and water reabsorption and promotes K excretion-meds and nursing
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HCTZ, Hydrodiuril. It is sulfa based to check for sulfa allergies, monitor BP, I&O, K levels and dehydration
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Vasodilators cause systemic vasodilation, decreases preload and afterload/SVR, increase blood flow to the heart- meds and nursing
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Nitrates (Sublingual for HTN crisis, patch-long acting).
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Central Acting Inhibitors act on CNS in the brain, inhibits vasoconstriction-meds/nursing
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Catapres, Wytensins, Aldomet (older group), Othostasis
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Alpha adrenergic blockers peripheral vasodilators act directly on the blood vessles (older group)-meds/nursing
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Minipres, Hytrin (older group). Othostasis
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Betablockers blocks responses to the SNS stimulation therby preventing vasoconstriction and tachycardia. Results in decreased BP and heart rate. Meds/nursing
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LOL meds-Lopressor (metoprolol), Tenormin (atenolol), Corgard (nadolol). Check BP and pulse. Don't admin. to COPD pt and don't stop suddenly
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Alph and Beta blockers can be admin. IV in a hypertensive emergency. Meds/nursing
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Normodyne (labetolol), Coreg (cavedilol). Close monitoring of BP, don't admin. to COPD pt.
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ACE inhibitors inhibit conversion of angiotension I to angiotension II thereby inhibiting vasoconstriction. Meds/nursing
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Capoten (captopril), Vasotec (enalapril) -PRIL meds. fist line therapy, used to prevent heart attack and for renal protection in diabetics. Can lead to dry cough and due to this med non-compliance
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ACE II useful in renal pt. very expensive. meds/nursing
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Cozaar and Diovan. check BP, pulse, monitor for headache, dizziness and cough
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Ccb-calcium changel blockers relax smooth muscles in the arterial walls, dilate coronary arteries. meds/nursing
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Calan, Cardizem, Procardia. Check BP, pulse. Do not give to pt. in heart block (heart is a muscle)
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Calcium causes
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tetany (spasms)
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Hypertensive crisis the goal is to
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prevent target organ damage of the heart, brain and/or kidneys
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A HTN crisis is a
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rapid rise in BP, systolci is over 240 and diastolic is over 120
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You want a gradual reduction in BP in HTN crisis, why?
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B/C a rapid decrease can result in stroke (bottoming out), MI.
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When do you see HTN crisis
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in pt. who suddenly stop HTN meds, pt. who abuse stimulants, pt. with MI, intracrainal hemmorage, ecclampsia.
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S/S of HTN crisis related to cerebral edema and spasm of cerebral vessels
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headache, nausea, vomiting, seizure, confusion, coma, blurred vision, transient blindness, angina and dyspnea are related to SVR
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Treatment of HTN crisis
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potent and direct IV vasodilators such as labatolol, hyperstat, Nipride and nitroglycerine (must have special tubing-nitro is an explosive).
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