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The flashcards below were created by user
britsands
on FreezingBlue Flashcards.
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What caused preload to be increased
- Hypervolemia
- Regurgitation of the valves
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What increases afterload
- Vasoconstriction
- increase afterload= increase workload
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The five factors of Blood Pressure
- Cardiac
- sympathatic nervous system
- Local regulation
- renal fluid volume control
- humoral
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Renin angiotensin aldosterone cycle?
increased aldosterone---->
- increased sodium retention
- increased water reabosorption
- increased blood volume
- increased cardiac output
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Prehypertension:
120-139/80-89
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hypertension stage 1
140-159/90-99
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Hypertension stage 2
Greater than or equal to 160/100
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MAP equation
- (2)diastolyic + systolic 3
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Primary hypertension happens in what percentage of people
Secondary?
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Secondary hypertension is high in what?
Childern
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Secondary Hypertension
what is it?
Causes of it?
- Elevated BP with a specific cause
- coarctation of aorta
- renal disease
- endocrine disorders
- neurologic disorders
- cirrhosis
- sleep apnea
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Hypertension target organ damage
Heart-
- Coronary artery disease
- left ventricular hypertrophy
- heart failure
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Hypertension target organ damage
Cerbrovascular disease
- Stroke!
- retinal damage (should get checked every 6 months
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Hypertension target organ damage
kidney
- nephrosclerosis
- renal failure
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Diagnostic tests for hypertension
- urinalysis, creatinine clearance
- serum electrolytes, glucose
- BUN and serum creatinine
- Serum lipid profile (ldl, hdl, total cholersterol)
- ecg
- echocardiogram
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Drugs currentlly available fro treating hypertension work by either what 2 ways
- 1) decreasing the volume of circulating blood and/or
- 2) reducing SVR
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Weightloss of 10kg may decrease systolic by aprox what amount?
5-20
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What should you monitor for whith drug side effects?
- orthostatic hypotension
- sexual dysfunction
- dry mouth
- frequent urination
- coughing
- high or low potassium
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What dietary teaching should you educate
- less that 2.4 g of Na+
- greater values of potassium , calcium, vit D, and omega 3-fatty acids
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What should you teach patients about how to track their hypertension?
- have them keep a log
- check twice a day, in the morning and before bed
- teach what to watch for (swelling, headache)
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When is a second drug added to reginmen
- thiazide diuretics 1st step
- bp is more than 20/10 mm Hg above SBP and DBP goals, a second drug is added
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What is the diastolic have to be abruptly for hypertension crisis
>140
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what is the most effective drug for hypertension crisis
sodium mitroprusside
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Hydrochlorothiazide
Thiazide diuretic
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Bumetanide (bumex)
Furosemide (lasix)
Loop diuretic
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Aldactone
- Aldosterone receptor blockers
- Potassium sparing diuretic
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Clonidine (Catapres)
- Central-acting adrenergic antagonists
- (reduces peripheral sympathetic tone, produces vasodialation, decreases svr and bp)
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Doxazosin (cardura)
Prazosin (Minipress)
- A1- adrenergic blockers
- produces peripheral vasodialation (decreases svr and bp)
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Hydralazine (apresoline)
- direct vasodialtors
- reduces SVR and BP by direct arterial vasodialation for crisis hypertension
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amlodipine (norvasc)
nifedipine (procardia)
verapamil
- Ca+ channel blocker
- vasodialation and decreased HR
- use cautiously in patients with heart failure or 2nd or 3rd heart block
- avoid grapefruit
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