Assessent and Management of Pateints with Hypertension

Prolonged hypertension can cause significant damage to blood vessels in four "target organs": ___________________________, ___________________________, _____________________________, and _______________________________________.

. heart, kidneys, brain, and eyes

BP Should vary by no more than _______________?

5mm Hg between arms

Approximately ________% of the population has primary hypertension, a class of hypertension with an unidentified cause.

90% to 95%

Inhibits aldosterone

Aldactone

Teach Pt. to adopt the DASH eating plan. When nurse teaches the pt. what will she teach them?

Consume a diet rich in fruits, vegetables, and low-fat dairy products with a reduced content of saturated and total fat. 7-8 Servings/day of Grains Veg:4/5 Fruits: 4/5 low fat or fat-free dairy foods 2-3 Meat, fish, poultry <2 Nuts, seeds and dry beans 4-5 wkly

Decreases blood volume, renal blood flow, and cardiac output

Hygroton

Blocks beta-adrenergic receptors

Inderal

What med Blocks reabsorption of sodium and water in kidneys?

Lasix

What gerontologic consideration would you moinotor for pt on BP Meds. ie; Diuretic

Risk of postural hypo-tension is significant b/c of volume depletion; measure bp in 3 positions; caution pt to rise slowly.

Impairs synthesis of norepinephrine

Serpasil

Stimulates alpha-2 adrenergic receptors

Tenex

Structural and functional changes in the heart and blood vessels that occur with aging and cause hypertension are: ____________________________, _____________________________, __________________________, and ____________________________.

accumulation of atherosclerotic plaques, fragmentation of arterial elastins, increased collagen deposits, and impaired vasodilation

Give four examples of conditions that can trigger a hypertensive emergency in which blood pressure must be immediately lowered to at least 180/120 mm Hg: _____________________, _____________________, _____________________, and _____________________.

acute myocardial infarction, a dissecting aortic aneurysm, an intracranial hemorrhage, and hypertension associated with pregnancy

The desired goal for the systolic blood pressure for a person with diabetes mellitus or chronic kidney disease is: a. 120 mm Hg. b. 130 mm Hg. c. 140 mm Hg. d. 150 mm Hg.

b. 130 mm Hg.

An expected nursing diagnosis for a patient with hypertension is: a. heart failure. b. knowledge deficit. c. myocardial infarction. d. renal insufficiency.

b. knowledge deficit.

Georgia, a 30-year-old woman, is diagnosed as having secondary hypertension when serial blood pressure recordings show her average reading to be 170/100 mm Hg. Her hypertension is the result of renal dysfunction. The kidneys help maintain the hypertensive state in essential hypertension by: a. increasing their elimination of sodium in response to aldosterone secretion. b. releasing renin in response to decreased renal perfusion. c. secreting acetylcholine, which stimulates the sympathetic nervous system to constrict major vessels. d. doing all of the above.

b. releasing renin in response to decreased renal perfusion.

The percentage of adults in the United States who have hypertension is approximately: a. 10%. b. 15%. c. 30%. d. 40%

c. 30%

Blood pressure control is initially achieved by approximately what percentage of patients when they actively participate in their care? a. 10% b. 25% c. 35% d. 70%

c. 35%

The percentage of patients with hypertension who discontinue their drug therapy, without physician direction, within 1 year after its initiation is estimated to be: a. 15%. b. 30%. c. 50%. d. 75%

c. 50%.

Pharmacologic therapy for patients with uncomplicated hypertension would include the administration of: a. Angiotensin-converting enzyme inhibitors. b. alpha-blockers. c. beta-blockers. d. calcium antagonists

c. beta-blockers.

Georgia is prescribed spironolactone (Aldactone), 50 mg once every day. The nurse knows that spironolactone: a. blocks the reabsorption of sodium, thereby increasing urinary output. b. inhibits renal vasoconstriction, which prevents the release of renin. c. interferes with fluid retention by inhibiting aldosterone. d. prevents the secretion of epinephrine from the adrenal medulla.

c. interferes with fluid retention by inhibiting aldosterone.

One of the most significant concerns for medical and nursing management of hypertension is: a. complications from medications. b. insufficient information. c. noncompliance with recommended therapy. d. uncontrolled dietary management.

c. noncompliance with recommended therapy.

Blood pressure is the product of ________________ multiplied by ________________.

cardiac output; peripheral resistance

Stage 1 hypertension is defined as persistent blood pressure levels in which the systolic pressure is higher than ____ and the diastolic is higher than ____. a. 110/60 mm Hg b. 120/70 mm Hg c. 130/80 mm Hg d. 140/90 mm Hg

d. 140/90 mm Hg

A characteristic symptom of damage to the vital organs as a result of hypertension is: a. angina. b. dyspnea. c. epistaxis. d. all of the above.

d. all of the above.

Prehypertension, a precursor to hypertension, can be diagnosed when the diastolic reading is: a. between 60 and 70 mm Hg. b. at 75 mm Hg. c. at 80 mm Hg. d. between 85 and 90 mm Hg.

d. between 85 and 90 mm Hg. less then 120/80 mm Hg diastolic is normal. 120 to 129/80 to 89 mm Hg is labeled as prehypertension.

Health education for Georgia includes advising her to: a. adhere to her dietary regimen. b. become involved in a regular program of exercise. c. take her medication as prescribed. d. do all of the above.

d. do all of the above.

Renal pathology associated with essential hypertension can be identified by: a. a urine output greater than 2,000 mL in 24 hours. b. a urine specific gravity of 1.005. c. hyponatremia and decreased urine osmolality. d. increased blood urea nitrogen and creatinine levels.

d. increased blood urea nitrogen and creatinine levels. Normal levels: BUN7-22 mg/dl Creatinine: 0.6-1.35 mg/dl

Cardiac output is the product of ________________ multiplied by ________________.

heart rate; stroke volume

List six consequences of prolonged, uncontrolled hypertension on the body and its systems.

myocardial infarction, heart failure, renal failure, stroke, impaired vision, and left ventricular hypertrophy