NURS 51 Exam 2

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NURS 51 Exam 2
2011-09-12 16:17:02
Nursing 51 Exam HTN Inflammatory Structural Heart Disorders Vascular

Exam 2
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  1. Pre HTN
    120-139/ 80-89
  2. HTN I
    (140-159/ 90-99)
  3. HTN II
    (> 160/ > 100)
  4. Major Danger of HTN II
    Strokes especially those prone to aneurysms
  5. BP formula
    BP= CO x SVR
  6. BP Regulating Mechanisms
    -Short Term Mechs
    -Long Term Mechs
    • -Sympathetic nervous system, baroreceptors, Vascular endothelium
    • -Renal and Hormonal Processes
  7. Norepinephrine
    -Effects on α-1, α-2, ß-1, ß-2, dopamine receptors
    • A short term BP regulating mechanism part of the Sympathetic Nervous system.
    • α-1 Vasoconstrict, ↑contractility
    • α-2 Vasoconstrict
    • ß-1 ↑ contractility, HR, conduction, renin secretion
    • ß-2 Vasodilation
    • Dopamine Vasodilation
  8. Baroreceptors
    -↑ BP effects
    -↓ BP effects
    -Long term HTN effects
    • Short term BP regulatory mechanism
    • -Carotid aorta and aortic arch
    • - Inhibitory impulses sent to sympathetic vasomotor complex in the brain-- causes decreased HR and Contractility and peripheral vasodilation
    • - Stimulates kidneys to release renin which cause peripheral arteries to contract, increased HR and contractility.
    • -Desensitizes receptors will not respond to increased BP so inhibitory impulses will not be sent to brain and BP will not be lowered by this mechanism.
  9. Vascular Endothelium
    Releases vasoactive substances and growth hormones in response to changes in the arteries including Nitric Oxide, Endothelin, Prostacyclin
  10. Nitric Oxide
    • Released by vascular endothelium
    • Keeps arterial muscle wall relaxed at rest, inhibits smooth muscle growth, inhibits platelet aggregation
  11. Prostacyclin
    • Released by vascular endothelium
    • Vasodilates
  12. Endothelin
    • Released by vascular endothelium
    • Vasodilates
    • -ET-1 is most potent vasodilator, also stimulates smooth muscle growth and neutrophil aggregation.
  13. RAAS
    • Long term BP regulatory mechanism.
    • Baroreceptors in the Kidneys release renin in response to hight BP.
    • Renin converts Ang 1 to Ang 2
    • Angiotensin II vasoconstricts which increases SVR and BP
    • Angiotensin II also stimulates the release of aldosterone from the adrenals which tells the kidneys to retain Na and H2O which increases ECF, Blood Volume and BP
  14. Epinephrine
    Increases HR and Contractility--> CO
  15. Isolated Systolic Hypertension
    • Systolic > 140 while Diastolic <90
    • Common in the elderly as SBP rises with age
    • DBP increases until ~ 55yo then declines due to decreased elasticity and arteriosclerosis
  16. Pseudohypertension
    • When the blood pressure cuff isn't able to occlude sclerotic arteries resulting in higher readings.
    • An intraarterial catheter may be used to measure BP in these pts.
  17. Why Age increases BP
    • Arteriosclerosis/atherosclerosis increasing with age
    • – After age 50, SBP>140 is more important than DBP
    • – ↓ elasticity in large arteries due to atherosclerosis
    • – ↑ collagen and stiffness of myocardium
    • – ↑ PVR
    • – ↓ adrenergic receptor sensitivity, baroreceptor reflexes
    • – ↓ renal function = ↓ renin response to Na/H20 depletion,excretion of meds prolonged
    • – ↓ blood flow to gut = ↓ med absorption