CCC1 - Hypertension

What four control systems regulate blood pressure in the body?

Arterial baroreceptor system, regulation of body fluid volume, renin-angiotensin-aldosterone system (RAAS), and vascular autoregulation $

What does the arterial baroreceptor system do?

Detects changes in blood pressure and adjusts heart rate and vessel tone $

How does regulation of body fluid volume affect blood pressure?

The kidneys control sodium and water balance which affects blood volume and BP $

What is the role of the renin-angiotensin-aldosterone system (RAAS)?

Causes vasoconstriction and sodium/water retention to increase blood pressure $

What is vascular autoregulation?

Blood vessels constrict or dilate to maintain adequate tissue perfusion $

What blood pressure reading is considered hypertension?

BP ≥130/80 mmHg on two or more assessments at least 2 weeks apart $

What are the two main types of hypertension?

Essential (primary) hypertension and secondary hypertension $

What are the blood pressure ranges for Stage 1 hypertension?

SBP 130–139 or DBP 80–89 $

What are the blood pressure ranges for Stage 2 hypertension?

SBP ≥140 or DBP ≥90 $

What blood pressure defines a hypertensive crisis?

SBP >180 or DBP >120 $

What are common symptoms of hypertensive crisis?

Blurred vision, headache, and dyspnea $

What is essential (primary) hypertension?

The most common type of hypertension with no identifiable cause $

What structural change in arteries occurs with essential hypertension?

Medial hyperplasia (thickening of artery walls) $

What is a major consequence of untreated essential hypertension?

Damage to vital organs $

What are common risk factors for essential hypertension?

African American ethnicity, hyperlipidemia, smoking, age over 60, obesity, and physical inactivity $

What is secondary hypertension?

Hypertension caused by an identifiable underlying condition $

What kidney-related condition can cause secondary hypertension?

Kidney disease $

What endocrine condition involving excess aldosterone can cause hypertension?

Primary aldosteronism $

What tumor of the adrenal gland can cause hypertension?

Pheochromocytoma $

What hormonal disorder involving excess cortisol can cause hypertension?

Cushing’s disease $

What congenital heart defect can cause hypertension?

Coarctation of the aorta $

What neurological causes can lead to secondary hypertension?

Brain tumor or encephalitis $

What pregnancy condition can cause hypertension?

Pregnancy-related hypertension $

What medications can cause secondary hypertension?

Estrogen, glucocorticoids, mineralocorticoids, and sympathomimetics $

What should be assessed in the history of a patient with hypertension?

Risk factors, kidney or cardiovascular disease, medication use, and illicit drug use $

Why is hypertension often called a “silent disease”?

Many patients have no symptoms $

What common symptoms may occur with hypertension?

Headache, vision changes, dizziness, and fainting $

What eye exam can detect damage from hypertension?

Fundoscopic examination $

What does the presence of abdominal bruits suggest in hypertension assessment?

Possible renal artery stenosis $

What psychosocial factors should nurses assess in hypertensive patients?

Stress, lifestyle habits, and ability to follow treatment plans $

What blood tests help evaluate kidney function in hypertension?

BUN and creatinine $

What imaging test may show an enlarged heart due to hypertension?

Chest X-ray $

What cardiac test is commonly used to assess heart effects of hypertension?

ECG $

What is the primary goal of nursing implementation for hypertension?

Promote adherence to the plan of care $

What diet is recommended to help reduce blood pressure?

DASH diet (Dietary Approaches to Stop Hypertension) $

What foods are emphasized in the DASH diet?

Vegetables, fruits, whole grains, and foods rich in potassium, calcium, and magnesium $

What nutrient should be limited in the DASH diet?

Sodium $

What are the characteristics of a heart-healthy diet for hypertension?

Low sodium, low fat, and low cholesterol $

What do diuretics do in hypertension treatment?

Remove excess sodium and water to lower blood pressure $

What do thiazide diuretics do?

Inhibit sodium and water reabsorption and increase potassium excretion $

What do loop diuretics do?

Decrease sodium reabsorption and increase potassium loss $

What do potassium-sparing diuretics do?

Prevent sodium reabsorption in exchange for potassium $

What electrolyte should nurses monitor when patients take diuretics?

Potassium $

What electrolyte imbalance can occur with thiazide or loop diuretics?

Hypokalemia $

What electrolyte imbalance can occur with potassium-sparing diuretics?

Hyperkalemia $

How do calcium channel blockers lower blood pressure?

Block calcium movement into cells causing vasodilation $

What patient teaching is important with calcium channel blockers?

Change positions slowly and avoid grapefruit juice $

What should nurses monitor when patients take calcium channel blockers?

Hypotension and heart rate changes or heart block $

How do ACE inhibitors lower blood pressure?

Block conversion of angiotensin I to angiotensin II, preventing vasoconstriction $

What common side effect occurs with ACE inhibitors?

Dry cough $

What should nurses monitor when patients take ACE inhibitors?

Hypotension and edema $

How do angiotensin receptor blockers (ARBs) work?

Block angiotensin II receptors to decrease peripheral resistance $

What complications should be monitored with ARBs?

Angioedema, heart failure, and hyperkalemia $

How do beta blockers lower blood pressure?

Block beta-adrenergic receptors, slowing heart rate and lowering BP $

What should nurses monitor when patients take beta blockers?

Bradycardia and hypotension $

What important teaching should be given about beta blockers?

Do not stop taking them suddenly $

How do central alpha-2 agonists lower blood pressure?

Decrease peripheral vascular resistance by inhibiting norepinephrine reuptake $

Are central alpha-2 agonists first-line therapy for hypertension?

No $

How do alpha adrenergic antagonists lower blood pressure?

Cause vasodilation $

What is an important nursing consideration when starting alpha adrenergic antagonists?

Monitor for postural hypotension $

What is the priority treatment for hypertensive crisis?

IV antihypertensive medications $

How often should blood pressure be monitored during hypertensive crisis treatment?

Every 5–15 minutes $

What is the blood pressure reduction goal in the first hour of hypertensive crisis treatment?

Lower BP by 20–25% $

What blood pressure should not be dropped below initially during hypertensive crisis treatment?

140/90 $

What neurologic assessment should be performed during hypertensive crisis?

Monitor neurologic status $

What cardiac monitoring should be used during hypertensive crisis?

Continuous EKG monitoring $