Medical-Surgical Nursing, 11th Ed., Harding, Kwong, Roberts, Hagler & Reinisch | Registered Nurse (RN) School Study Aid
Primary Hypertension Risk Factors
- Excessive Alcohol Consumption
- High Sodium Diet
- Dyslipidemia
- Obesity
- People of African Descent
- Advanced Age
- Vitamin D Deficiency
- Reduced Nephron Number
- Diabetes
- Lack of Physical Activity
Blood Pressure Classification (JNC 7)
- Normal
- Systolic (<120)
- Diastolic (< 80)
- Prehypertension
- Systolic +20 (120-139)
- Diastolic +10 (80-89)
- Stage 1 Hypertension
- Systolic +20 (140-159)
- Diastolic +10 (90-99)
- Stage 2 Hypertension
- Systolic + > 20 (160)
- Diastolic + > 10 (100)
- Hypertensive Crisis
- Systolic > 180
- Diastolic > 110
Hypertension Assessment
- Essential Hypertension
- Secondary Hypertension
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Take BP Both Arms
- Common in African Americans
Hypertension Intervention
- Weight Reduction and Exercise
- Diet Changes
- Relaxation Techniques
- Smoking Cessation
- Medications
- Encourage Self Monitoring
Hypertension Medications
- Diuretics
- ACE Inhibitors
- Angiotensin Receptor Blockers (ARBs)
- Beta Blockers
- Dihydropyridine Calcium Channel Blockers
High Blood Pressure Response
- Atria Release Atrial Natriuretic Peptide
- Vasodilation
- Antagonizes Aldosterone
- Na+ and Water Excreted
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Hypertension
- Heart Failure
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Slowly Change Position
- Do Not Stop Abruptly
Loop Diuretics
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl-
- Sulfa Drug
- Furosemide
- Lasix
- Ototoxicity from Rapid Injection
- Gout
- Dehydration
- Hypocalcemia
- Hypokalemia
- Orthostatic Hypotension
Ethacrynic Acid
- Non-sulfa Drug
- Phenoxyacetic Acid Derivative
- Loop Diuretic
- Inhibits Na+-K+-2Cl- Cotransporter
- Thick Ascending Loop of Henle
- Diuresis
- Hypokalemia
- Ototoxicity
- Gout
K+ Sparing Diuretics
- CHF and Hypertension
- Hypokalemia
- Hyperaldosteronism
- Collecting Tubule
- Spironolactone
- Competitive Aldosterone Receptor Antagonist
- Amiloride and Triamterene
- Block Na+ Channels
- Hyperkalemia
- Gynecomastia
Spironolactone (Aldactone)
- Inhibition of Aldosterone
- Potassium Retention
- Hypertension
- Edema
- Heart Failure
- Hyperkalemia
- Endocrine Effects
- Avoid Potassium Supplements
Beta Blockers
- "-olol" suffix
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Hypertension
- Heart Failure
- Angina Pectoris
- Asthma and Heart Block Patients
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
Prazosin (Minipress)
- -osin suffix
- Selective Alpha-1 Receptor Blocker
- Hypertension
- Benign Prostatic Hyperplasia (BPH)
- Nightmares
- Orthostatic Hypotension
- Tachycardia
- Priapism / Inhibition of Ejaculation
- Nasal Congestion
- First Dose Effect
- Administer at Bedtime