blood pressure

systolic pressure

ventricles contract and pump blood into arterial circulation

diastolic pressure

heart is filling

desired BP for people >60

below 150/90

desired BP for people <60

below 140/90

what is the most common type of hypertension

primary hypertension

primary or secondary hypertension results in damage to vital organs

primary

primary or secondary hyeprtension’s causes medial hyperplasia (thickening) of arterioles

primary

common risk factors of primary hypertensions

obesity

smoking

stress

family history

what causes secondary hypertension

Cushing syndrome

hyperthyroidism

chronic renal disease

certain drugs

morning headaches, blurred vision, dyspnea, and uremia are symptoms of what

hypertension

what BP indicated a hypertensive crisis

< or equal to 180/120 mm Hg

_____ million adults older than 20 years old have hypertension

121.5

diet for those with hypertension

DASH diet

cues of hypertension based on patient history

risk factors

kidney or cardiovascular disease

durg therapy or illicit drug use

diagnostic assessments for hypertension

urinalysis for protein, RBC, BUN, creatine

chest x-ray (cardiomegaly)

ECG shows degree of cardiac involvement

medication for those with stage 1 HTN

nonpharmolgic therapy and an antihypertensive medication

medication for those with stage 2 HTN

nonpharmologic therapy and two antihypertensive medications

hypertension stage 1 level (systolic)

130-139 mmHg

hypertension stage 1 level (diastolic)

80-89 mm Hg

hypertension stage 2 level (systolic)

greater or equal to 140

hypertension stage 2 level (diastolic)

greater or equal to 90

synergistic blood pressure reduction

prescribing two antihypertensives from different drug classes creates an additive affect

when is prescribing two antihypertensives from different drug classes necessary

when patient has not responded to the initial medication, has a compelling condition, or has very high, sustained BP

what is the advantage of prescribing two drugs for HTN

lower doses of the drugs, will result in fewer side effects and better patient adherence to the therapy

primary antihypertensive agents

diuretics

ace inhibitors

ARBs

CCBs

three diuretics

potassium sparing

loop

thiazide

ex of potassium sparing drug

spironolactone

ex of loop drug

furosemide

ex of thiazide drug

hydroclhlorothiazide

what drug increased urinary excretion of water and electrolytes; thereby reducing blood volume

diuretics

when should a diuretic be taken

in the morning to prevent nocturia

what drug is used for mild to moderate hypertension

diuretics

what drug inhibits sodium, chloride, and water reabsorption in the distal tubules

hydrochlorothiazide

what gets excreted with hydrochlorothiazide drugs

potassium

bicarbonate

magnesium

hydrochlorothiazide decreased the chances of what health issues

kidney stones and bone loss due to decreasing calcium excretion

what drug should be used for treating fever and pain

acetaminophen

negative effects of thiazide diuretics

hyponatremia and can result in lithium accumulation and toxicity

what drug inhibits sodium, chloride, and water reabsorption in the ascending loop of Henle

loop diuretics

loop diuretics promote the excretion of what ions

potassium

in what patients should loop and thiazide agents be carefully administered

diabetics and gout

patients on loop and thiazide agents should eat food high in what

K+ and undergo lab test to monitor electrolyte level because these agents cause k and Mg2+ excretion

what drug has a limited effect on BP

spironolactone

what drug conserves potassium

spironolactone

what is spironaloctone commonly prescribed with to offset potassium loss

loop or thiazide diureitcs

what is an associated risk with spironolactone

hyperkalemia

potassium sparing diuretics function

medicines that increases diuresis (urination) without the loss of potassium

patient education when on potassium sparing diuretics

decrease itakes of food that are high in potassium, due to agents causing causing retention of K+ in the body

what symptoms may indicate hyperkalemia due to potassium-sparing agents

weakness and irregular pulse

how long before spironolactone/aldctone takes effect

48 hrs

examples of beta blockers

atenolol

metoprolol

what HR should you not administer HR

<50-60

what to assess before administering beta blockers

HR and BP

common adverse effect of beta blockers

orthostatic hypotension

examples of calcium channel blockers

verapamil

amlodipine

diltiazem

function of CCB

used to treat hypertension and other cardiovascular diseases

what drug slows down SA and AV conduction, which decreases HR and vasodilation and causes decreased BP

CCBs

what should be avoided when on CCBs

grapefruit juice, due to it causing organ dysfunction

examples of beta blockers

atenolol

metoprolol

beta-adrenergic blocker function

decrease HR and contractility; inhibits the secretion of renin

common side effect of beta-adrenergic blockers

sexual dysfunction

use beta blockers with caution in patients with who

diabetics, glucose production may be affected

examples of ACE Inhibitors

lisinopril

enalapril

captopril

common side effect of ACE Inhibitors

persistent, dry cough

what do ACE inhibitors do

reduce the excretion of potassium

most common form of cardiovascular disease

hypertension

HTN stage 1

130-139 HTN

HTN stage 2

140 and above

systolic pressure

ventricles contract and pump blood into arterial circulation

diastolic pressure

heart is filling

cardiac output

volume of blood pumped per minute

cardiac output determined by

stoke volume

heart rate

heart rate

it refers to the number of times the heart beats per minute

stroke volume

it refers to the quantity of blood pumped out of each ventricle with every heartbeat

peripheral vascular resistance

the friction and force from blood vessel walls that opposes blood flow and helps control blood pressure

blood volume

total amount of blood in vascular system

what hormones raise BP

epinephrine and norepinephrine

function of ADH

raises BP by raising blood volume

renin-angiotensin-aldsoterone system

primary homeostatic mechanism for controlling BP