Cardiology/hypertension
secondary hypertension is one that can be fixed and includes:
-renal disease -hyperaldosteronism -certain medications -pregnancy -coarctation of the aorta
electrocardiogram (ECG) reflects what?
This test will reflect any heart damage.
A client with the diagnosis of primary hypertension is started on a regimen of hydrochlorothiazide. The nurse is providing instructions regarding this medication. What information should the nurse include?
An antihypertensive medication will likely be required for the remainder of life
A nurse is teaching a client who is taking a loop diuretic about foods that are high in potassium. Which foods should the nurse emphasize? Select all that apply.
Bananas Apricots baked potatoes with skins
having high blood pressure for a long time and not doing anything about it can cause organ damage and are seen late and serious include:
CAD, left ventricular hypertrophy, kidney damage, cerebrovascular involvement, retinal changes
blood pressure equals
CO X peripheral resistance
A healthcare provider makes the diagnosis that an obese client has primary hypertension. Which priority information should the nurse include when preparing a teaching plan for this client?
Foods recommended on a low-calorie and low-sodium diet
After the nurse provides education about hydrochlorothiazide, the client will agree to notify the healthcare provider regarding the development of which symptom?
Generalized weakness is a symptom of significant hypokalemia, which may be a sequela of diuretic therapy
Which instruction would be most beneficial for an aging African-American client with hypertension?
Have an annual urinalysis
A nurse is assessing a client with the diagnosis of primary hypertension. Which clinical finding does the nurse identify as an indicator of primary hypertension?
Occipital headache in the morning
A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client's medication regimen?
To help prevent potassium loss
Routine lab ASSESSMENT AND DIAGNOSTIC FINDINGS OF HYPERTENSION
U/A evaluation for protein in urine blood chemistry (electrolytes-bun&creatine) 12 lead ecg echocardiogram
semilunar valves are the
aortic and pulmonic valves
Major action of a beta blocker (olols)
block the sympathetic nervous system, esp the sympathetics to the heart, producing a slower heart rate and lowered blood pressure [decreases heart rate and cardiac output]
rebound hypertension
blood pressure that is controlled with medication and becomes uncontrolled (abnormally high) with the abrupt discontinuation of medication.
Major action of Thiazide diuretics
decrease blood volume, renal blood flow and cardiac output
3 ways on how to treat hypertension
decrease peripheral resistance decrease volume decrease strength &/or rate of contraction
ACE inhibitors are indicated in pts with
diabetes, heart failure, and cardiovascular disease
Contraindications for Beta Blockers
do not give to pts with Asthma/Copd bc it constricts the smooth muscle
Side effects of Diuretics (thiazide, loop, potassium sparing, and combinations.)
dry mouth, thirst, nausea, weakness, drowsiness
cardiac output is defined as
heart rate X stroke volume
If the client has protein in the urine, this is a sign of ____________________ and can signify kidney damage.
high blood pressure
Primary hypertension
high blood pressure from an unidentifiable cause.
side effects of Calcium channel blockers
hypotension, brachycardia, CHF, dizziness, edema
Side effects of Beta blockers (olols)
hypotension, bradycardia, congestive heart failure, fatigue, depression, weakness, impotence, rebound htn, hypoglycemia
Side effects of ACE INHIBITORS (PRILS)
hypotension, tachycardia, hyperkalemia, azotemia, angioedema, dry hacking cough.
hypertension management with pharmacological therapy
initially - thiazide diuretic add- beta blocker calcium channel blockers ace inhibitors
Major action of Ace Inhibitors (Prils)
lower the total peripheral resistance
closure of what structure(s) produce the first heart sound (S1)
mitral and tricuspid valves
Nursing implications for diuretics
monitor postural hypotension, close attention to k+ levels
120 to 129/80 to 89 mmHg is defined as
prehypertension
Major action of calcium channel blockers
reduce cardiac afterload, decrease peripheral resistance
Contraindications of Calcium channel blockers
sick sinus syndrome, heart blocks
treatment of hypertension with life style modifications:
weigh reduction dash diet plan dietary sodium reduction regular physical activity reduce alcohol and sodium intake
