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 Blood Pressure Classification (ACC/AHA 2017)
Normal Systolic Less than 120 Diastolic Less than 80 Elevated Systolic +10 (120-129) Diastolic Less than 80 Stage 1 Hypertension Systolic +10 (130-139) Diastolic +10 (80-89) Stage 2 Hypertension Systolic +40 (140-179) Diastolic +30 (90-119) Hypertensive Crisis Systolic greater than or equal to 180 Diastolic greater than or equal to 120 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 Supine Hypotension (Vena Cava Syndrome)
Compression of the Vena Cava and Descending Aorta Hypotension Dizziness Tachycardia Decreased Renal Perfusion Decreased Uteroplacental Perfusion Side-lying Position 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 Peripheral Artery Disease (PAD)
Atherosclerosis Intermittent Claudication Pain with Exercise Paresthesias Arterial Ulcers Critical Limb Ischemia Amputation Ankle-Brachial Index (ABI) Arterial Ulcer Assessment
Absent or Decreased Pulses Intermittent Claudication Sharp Pain Dependent Rubor Well Defined Edges Over Bony Areas Smooth, Shiny Skin Toes, Heels, Lateral Lower Legs Cool Arterial Ulcer Interventions
Saline Dressing Structured Exercise Programs Fibrinolytics Antiplatelet Medication No Caffeine, Nicotine Surgery Chronic Venous Insufficiency (Venous Stasis Ulcer) Assessment
Venous Stasis Ulcer Uneven Edges Dull Persistent Pain Medial Malleolus Necrotic Normal Pulses Lower Leg Edema Bronze-Brown Pigmentation Warm Pruritus Chronic Venous Insufficiency (Venous Stasis Ulcer) Interventions
Frequently Elevate Legs Avoid Standing/Sitting for Long Periods of Time Elastic Compression Stockings Bilayer Artificial Skin Daflon Wound Dressings Proper Foot and Leg Care Superficial Thrombophlebitis
IV Catheter Irritation Erythema Cord-like Vein Edema Remove IV Catheter Elevate Warm Compress Rotate Sites Q3 Days Aseptic Technique Abdominal Aortic Aneurysm (AAA) Assessment
Atherosclerosis Bruit Pulsation in Abdomen Abdominal or Lower Back Pain Tearing Pain Ultrasound Rupture Shock Surgical Repair Sickle Cell Anemia Assessment
Hemoglobin S (Genetic Defect) Sickle Shaped RBCs Jaundice Vaso Occlusive Crisis Fever Priapism Severe Pain Prominent in African Americans May be Asymptomatic Increased Risk of Infection Sickle Cell Anemia Interventions
Increase Hydration Analgesics Oxygen Warm Compress Bone Marrow Transplant Hydroxyurea Avoid High Altitudes Prophylactic Antibiotics Avoid Strenuous Exercise Vaccines Venous Thromboembolism (DVT) Assessment
Venous Wall Inflammation caused by Thrombus Tenderness Edema Warmth Asymmetry Could be Asymptomatic Monitor for Pulmonary Embolism Venous Thromboembolism (DVT) Interventions
Anticoagulants Prevention Education Frequent Ambulation Leg Exercises Compression Stockings or SCD's Avoid Nicotine and Oral Contraceptives Surgery Hemoglobin
Hemoglobin Has Four Iron Hemes Lots Of Hemoglobin In Red Blood Cells High O2 Levels Increase O2 Binding High Temperature Reduces O2 Binding High CO2 Levels Reduce O2 Binding Low pH Reduces O2 Binding Myoglobin Binds Oxygen in Muscle View More
GET PLAYLIST