Hypertension

Which blood pressure reading would be considered prehypertension? 156 mm Hg/80 mm Hg 133 mm Hg/98 mm Hg 136 mm Hg/88 mm Hg 110 mm Hg/76 mm Hg

136 mm Hg/88 mm Hg Prehypertension is defined as SBP 120 to 139 mm Hg or DBP of 80 to 89 mm Hg.

Which patient has the highest risk of hypertensive problems? A 50-year-old obese male who smokes. A 60-year-old woman of low socioeconomic status. A 70-year-old male who is bedridden and overweight. A 35-year-old woman who drinks and has a stressful job.

A 50-year-old obese male who smokes.

Which patients are at risk of developing hypertension? Select all that apply. A patient who exercises 1-2 times per month A patient who drinks two beers on the weekend A patient who is 5 feet tall and weighs 225 pounds A patient previously diagnosed with type II diabetes A patient with a 20-year history of cigarette smoking A patient who eats high sodium, high cholesterol foods four days per week

A patient who exercises 1-2 times per month A patient who is 5 feet tall and weighs 225 pounds A patient previously diagnosed with type II diabetes A patient with a 20-year history of cigarette smoking A patient who eats high sodium, high cholesterol foods four days per week

Personal and social history risk factors for hypertension

Age—risk increases with age Alcohol consumption Tobacco use Diet—particularly sodium content Obesity—risk greatest with central abdominal obesity Low socioeconomic status Stress Gender—In people under 55, higher prevalence in men; in people over 64, higher prevalence in women Ethnicity—higher prevalence in African Americans Sedentary lifestyle

The nurse is caring for a patient with a blood pressure of 168/72. The patient complains of a headache and blurred vision. Which additional subjective information would indicate the presence of severe hypertension? Select all that apply. Angina Fatigue Dyspnea Dizziness Vomiting Palpitations

Angina Fatigue Dyspnea Dizziness Palpitations

Isolated Systolic Hypertension (ISH)

Average SBP of 140 mm Hg or more, coupled with an average DBP of less than 90 mm Hg. SBP increases with aging. DBP rises until approximately age 55 and then declines. Control of ISH decreases the incidence of stroke, heart failure, and death.

Which symptoms may indicate complications of hypertension? Select all that apply. Chest pain Severe myopia Severe headache Persistent cough Decreased urine output 3+ pitting edema in the lower extremities

Chest pain Severe myopia Severe headache Decreased urine output 3+ pitting edema in the lower extremities

Secondary hypertension

Develops from an identifiable, correctable cause, such as coarctation of the aorta

medical history risk factors for hypertension

Diabetes mellitus—also increases risk for complications Elevated serum lipids

primary hypertension

Elevated blood pressure that has no known, reversible cause. It accounts for 90% to 95% of all cases of hypertension. Changes in endothelial function result from vasoconstriction, increasing peripheral resistance, and forcing the heart to pump harder. Some risk factors for this peripheral resistance include vasodilating agents, increased SNS activity, overproduction of sodium-retaining hormones, increased sodium intake, greater-than-ideal body weight, diabetes, tobacco use, and excessive alcohol intake.

Which major diseases are often complications of uncontrolled hypertension? Select all that apply. Cancer Heart failure Lung disease Kidney disease Cerebral vascular accident (Stroke)

Heart failure, Kidney disease, and Cerebral Vascular accident (stroke)

Family history risk factors for hypertension

History of a close blood relative (e.g., parents, sibling) with hypertension

clinical manifestations of hypertension

Hypertension is often called the "silent killer" because the patient is often unaware of the condition until it has caused damage to major organs. Symptoms of hypertension result from the effects of hypertension, including poor perfusion on target organs, on blood vessels in the various organs and tissues, or from the increased workload of the heart. These symptoms include: Fatigue Activity intolerance Dizziness Palpitations Angina Dyspnea

diagnostic studies of hypertension

Patients should have their blood pressure closely monitored for signs of elevation. Repeated high blood pressure readings are required for a diagnosis of hypertension. The nurse should ensure that the blood pressure is taken correctly to prevent false high readings. Basic laboratory studies are performed to identify or rule out causes of secondary hypertension, evaluate target organ disease, determine overall cardiovascular risk, and establish baseline levels before initiating therapy. Basic diagnostic studies for patients with hypertension include: Urinalysis Blood urea nitrogen (BUN) Serum creatinine Serum electrolytes Glomerular filtration rate Blood glucose level Lipid profile Uric acid levels Electrocardiogram (ECG) If the patient's age, history, physical examination, or severity of hypertension points to a secondary cause, further diagnostic testing is indicated.

Why is hypertension often called the "silent killer"? High blood pressure persists until death. Once hypertension is diagnosed, it will ultimately lead to death. It is unknown what effects hypertension has on the body until death has occurred. Patients typically do not experience symptoms with hypertension prior to diagnosis.

Patients typically do not experience symptoms with hypertension prior to diagnosis.

Which criterion is necessary for a patient to progress from prehypertension to a diagnosis of hypertension? Profound urinary retention is present Persistent blood pressure above 140/90 mm Hg Single blood pressure reading above 138/89 mm Hg A blood pressure increase in the systolic by 10 mm Hg

Persistent blood pressure above 140/90 mm Hg

Prehypertension

SBP 120-139 mm Hg or DBP 80-89 mm Hg

Defining secondary hypertension

Secondary hypertension is elevated BP with an identifiable, correctable cause. Causes of secondary hypertension include: coarctation of the aorta or congenital narrowing of the aorta renal artery stenosis endocrine disorders such as Cushing syndrome cirrhosis neurologic disorders such as brain tumors and head injury sleep apnea pregnancy-induced hypertension Treatment of secondary hypertension is directed at removing or treating the underlying cause.

Which diagnostic test can assess for target organ disease caused by hypertension? Serum sodium Serum albumin Serum creatinine Serum potassium

Serum creatinine The serum creatinine measures kidney function. An elevated level can indicate organ damage from hypertension.

Which diagnostic tests would be ordered to screen for kidney involvement in a patient with hypertension? Select all that apply. Urinalysis Sodium levels Chloride levels Creatinine levels Blood urea nitrogen levels

Urinalysis, creatinine levels, Blood urea nitrogen levels

Which snack selection increases the risk for primary hypertension? Fresh fruits French fries Chocolate milk Flank steak wrap

french fries

A patient with an adrenal tumor has consistent blood pressure readings of 152/86. Which one of the classifications would this disorder represent? High blood pressure Primary hypertension Secondary hypertension Isolated diastolic hypertension

secondary hypertension

clinical manifestations and complications of hypertension

stroke, blindness (retinal damage), arteriosclerosis (blood vessel damage), heart attack, heart failure, kidney failure. The organs associated with these are especially susceptible to pressure and perfusion changes caused by systemic vascular resistance.