Perfusion - DR. COKER, DNP-RN

Flashcards covering key concepts from the Perfusion lecture by Dr. Coker, DNP-RN, including definitions, types of hypertension, risk factors, assessments, nonpharmacological and pharmacological interventions.

What is the definition of blood pressure (BP)?

Blood pressure (BP) is the force exerted by circulating blood on the walls of blood vessels.

What is the necessary Mean Arterial Pressure (MAP) range to maintain tissue perfusion?

A MAP between 60-70 mm HG is necessary to maintain perfusion.

How is Cardiac Output (CO) calculated and what is its connection to perfusion?

CO = Heart Rate × Stroke Volume; central perfusion depends on sufficient CO, and inadequate CO means reduced organ blood flow.

Why is hypertension often referred to as the 'silent killer'?

It may show no symptoms, but it increases the risk for heart disease and stroke.

What is the definition of hypertension (HTN)?

Hypertension is a sustained elevation in blood pressure that increases the workload of the heart and arteries, leading to damage of blood vessels and organs.

According to current guidelines, what blood pressure classification is considered 'Normal'?

Systolic BP less than 120 and Diastolic BP less than 80.

What is the difference between Essential (Primary) and Secondary Hypertension?

Essential hypertension has no identifiable cause (most common), while secondary hypertension results from identifiable causes such as kidney disease or hormone disorders.

List some common risk factors for Essential Hypertension.

Age >60, family history, African American ethnicity, obesity, excessive sodium/caffeine, sedentary lifestyle, stress, alcohol, hyperlipidemia, smoking, and low K+/Ca2+/Mg2+ intake.

What are some common triggers for Secondary Hypertension?

Kidney disease, primary aldosteronism, pheochromocytoma, Cushing's syndrome, coarctation of the aorta, and certain medications (e.g., oral contraceptives, steroids).

What key data should be collected when assessing a patient's risk factors for hypertension?

Patient’s age, ethnic origin or race, family history, average dietary intake of calories, sodium/potassium, and alcohol, exercise habits, kidney/CVD history, and current drug therapy/illicit drug use.

What are some common signs and symptoms that might be experienced by patients with chronic hypertension, despite many being asymptomatic?

Headache, dizziness, lightheadedness, blurred vision, chest pain, fatigue, confusion, and palpitation.

What laboratory tests can assess for possible causes of secondary hypertension and what do they indicate?

Creatinine & BUN (kidney damage), Electrolytes (aldosterone issues/med effects), TSH (thyroid-related HTN), ECG (arrhythmias/ischemic changes), and Chest X-Ray (cardiomegaly/heart failure).

Which population groups are primarily at risk for hypertension?

Risk increases with age (>60), African Americans have higher prevalence and earlier onset, and a greater percentage of men have high blood pressure than women.

What nonpharmacological interventions are recommended for controlling/managing hypertension?

DASH Diet, sodium restriction, weight loss, regular exercise (150 min/week), reduced alcohol intake, quitting smoking, and stress management.

What are the first-line drug classes for pharmacological intervention in hypertension?

Thiazide diuretics, Calcium Channel Blockers (CCB), ACE inhibitors, and ARBs.

What are some common side effects of antihypertensive drug therapy?

Orthostatic hypotension, sexual dysfunction, dry mouth, and frequent urination (for diuretics).

What specific considerations should be known for potassium-wasting diuretics like Furosemide and Hydrochlorothiazide?

They can cause low K+, so patients should eat foods with K+ such as melons, bananas, and green leafy vegetables.

What specific consideration should be known for the potassium-sparing diuretic Spironolactone?

It spares potassium, so patients should avoid salt substitutes, melons, and green leafy vegetables (foods high in K+).

Which drug class 'calms BP & HR' and should be avoided in patients with low heart rate and blood pressure?

Calcium Channel Blockers (e.g., Nifedipine, Amlodipine).

What are key side effects and contraindications for ACE Inhibitors (e.g., Lisinopril)?

Avoid in pregnancy, may cause angioedema (airway risk), dry cough, and elevated K+.

What are key side effects and contraindications for ARBs (e.g., Losartan)?

Avoid in pregnancy and may cause elevated K+.