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Catagories of Hypertension
- Prehypertension: 120-139/80-89
- Stage 1: 140-159/90-99
- Stage 2: 160/100
Damage by sustained Hypertension
- Heart- works harder=heart failure
- Brain- damages vessels carrying blood and oxygen in brain can lead to TIA and CVA
- Renal Function- vascular damage in arteries of kidneys lead to progressive loss of function
- Eyes- vessels in retina can rupture or become occluded leding to visual impairment or blindness
What lab results are most important for Diuretics and Digoxin?
What should Asthma patients NOT take?
What can happen when an ER patient comes in with really high BP and is given a vasodilator to lower it?
BP can rise due to autoresponse
Cardia Output x Systemic vascular resistance=
What can Beta Blockers do to heart rate?
What is the correlation between chronic hypertension and heartfailure?
When the BP is always high, the heart works harder and gives out
- most common body fat
- work most when body needs energy
- essential to building plasma membranes
- lecithins best known
- most widely known
- most widely known for role in promoting atherosclerosis
- Report any muscle aches or weakness (can lead to rhaodomyolysis)
- give in evenings b/c cholesterol biosynthesis is higher at night.
- Lipitor, Pravachol, Crestor
- Do not give with other meds
- Give about 4 hours between meds
- often combined with statins
- Give aspirin 30 min b/4 to help prevent hot flashes and flushing se
- a B complex vitamin
- steady, intense, heavy chest pains
- starved for O2
- onset by exercise, caffiene, stress, alcohol
Heart Attack (MI)
part of the heart dies
What can NOT be taken with erectile dysfunction meds?
What do you check before giving Digoxin?
Apical pulse for a full minute
Left sided heart failure causes?
- Trouble breathing
- fluid backup in lungs
Right sided heart failure causes?
- Feet swelling
- Liver congestion (fills with blood, feels firm and engorged)
Sign of toxicity from Digoxin
Neasua is the most serious se
What do you check before giving Ace Inhibitors?
How does the diuretic HCTZ (Hydrochlorothiazide) work?
- lowers the blood volume to lower BP
- flushes all out through kidneys
What conditions complicate taking Beta Blockers?
What do you teach a patient about weight gain?
call Dr if gain 2lb/day or 5lb/week
What causes dysrhythmia?
High risk factors for high cholesterol?
age, high lipid levels, family history
Primary goal of Angina meds?
- Raise O2 supply
- Reduce O2 demand
What meds lower heart rate?
- beta blockers
- calcium channel blockers
Normal Potassium level
- call Dr if out of range (high or low) even if only a few pts
Major SE of anti-dysrythmics
can cause other disrythmic problems
- can have 1st dose phenomenon: profound hypotension
- end in PRIL
- dry cough most common se
- not for asthma or copd
Causes of Heart Failure
- Chronic hypertension
- Mocardial infarction (MI)
- Mitral Senosis
- Valvular heart disease
- Congenital heart disease
- Aging heart
Types of Diuretics
- Loop Diuretics: (Lasix)
- Potassium Sparing Diuretic: (Spironolactone)
Coronary Artery Disease (CAD)
- One of leading causes of mortality in US
- May be up to 50% or more occluded before any symptoms
- Clot Buster
- watch for orientation and alertness b/c could cause brain bleeding
Signs of Bleeding
- dark tarry stool
- bleeding gums
- Petechiae (small round red spots)
- Ecchymosis (bruising)
- Purpura (lg red/purple spots)
- Vital sign changes: increased heart rate, low blood pressure, increased resp
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