Hypertension

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Author:
vanwin
ID:
252364
Filename:
Hypertension
Updated:
2013-12-10 16:13:41
Tags:
Hypertension nursing medsurge
Folders:
MEDSURGE_E3
Description:
UTtyler nursing, don't go here
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  1. Vascular endotheliums responses to BP (2)
    • Nitric oxide: inhibits platelet aggregation & maintain low BP
    • enothelins: vaso constrictors & promote platelet aggregation
  2. Role of ANP& BNP
    antagonize aldosterone & ADH
  3. HTN classifications
    • Normal : <120 / <80 *and
    • PreHTN: 121-139 / 81-89
    • HTN1: 140-159 / 90-99
    • HTN2: 200/  >100
  4. HTN complications (5)
    • Hypertensive Heart disease
    • cerebrovascular disease
    • peripheral vascular disease
    • nephrosclerosis
    • retinal damage
  5. Left Ventricular Hypertrophy patho (2)
    • results from i↑ cardiac ouput & contractility demand
    • hypertrophied heart needs more O2 -> HF occurs when heart fails to meet this demand
  6. HTN encephalopathy
    when autoregualtion in brain fails to maintain constant BP in brain
  7. Nephrosclerosis patho (3)
    • ischemic nephrons r/t narrowing of lumen
    • atrophy of glomeruli & destruction
    • nephron death
  8. normal BP goals (2)
    • normal: <140 or <90
    • DM/ CKD: <130 and <80
  9. HTN initial BP check (4)
    • no caffeine, tobacco & exercise 30 mins b4
    • rest for 5 mins, legs uncrossed & arm at heart level
    • check both arms
    • recheck if difference is >5mmg (1min apart
  10. Postural BP check
    • Lay in bed 3-5 mins
    • take bp
    • sit up, take bp within 1-2 mins
    • stand and take bp within 1-2 mins
    • positive : ↓ 20 systolic/ 10 diastolic or HR ↑ by 20
  11. HTN gerontological considerations (4)
    • more susceptible to HTN - prone to dehydration
    • longer auscultatory gap
    • more rsistant to ARBs & ACE in hibitors
    • more sensitive to BPΔ
  12. HTN drugs teaching (4)
    • take meds at the same time daily
    • diuretics in the morning
    • OTC interactions
    • do not skip dose
  13. Types of HTN crises (2)
    • Hypertensive urgency: over few days -> weeks, call HCP & recheck BP
    • Hypertensive emergency: develops over hrs to days (220/140) *assess neuro!
  14. Risks of Hypertensive emergency (6)
    • *target organ damage!
    • intracranial hemorrhage
    • Acute L ventricular failure
    • Renal failure
    • Blurred vision
    • dissecting aorta
    • MI
    • Retinopathy
  15. S&S Hypertensive emergency(6)
    • severe HA
    • cardiovascular compromise: SOB/ angina
    • ↓ ouput- renal compromise
    • confusion
    • retinal hemorrhage
    • nausea
  16. HTN crisis treatment
    • *Lay them down!
    • IV Meds
    • Labetolol
    • Elanapril
    • Nitrodrip in ICU

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