BP
What is blood pressure?
It is the pressure of the blood as it is forced against the arterial walls.
What is systolic BP?
What is the nurse responsible for when delegating vital signs to a CNA?
1)It is the peak pressure against the arterial walls as the ventricles contract and eject blood. 2) interpretation
What is diastolic BP?
It is the minimum pressure against the arterial walls when the heart is at rest.
What is normal BP? Prehypertension? Hypertension stage 1? Hypertensions stage 2?
1) <120 and <80 2) 120-139 or 80-89 3) 140-159 or 90-99 4) >160 and >100
What are the three factors BP is influenced by and give and example for each
Cardiac function: stroke volume, heart rate
Peripheral Resistance: blood viscosity, arterial size and arterial compliance.
Blood Volume
What are the non-modifiable factors that affect BP?
developmental stages, gender, family history, genetics, and race.
What are modifiable factors that affect BP?
lifestyle, exercise, body position, stress, pain, obesity, and medications.
What read do you get if the cuff is too small/narrow? too large/wide?
1) false high 2)false low
What should the width of the cuff be? How long should you wait before rechecking BP? If it's above the heart level what would be your reading? below?
1) 2/3 length of upper arm 2) 1-2 min 3) lower 4) higher
Where should you NEVER take a BP? How much mm Hg does the right and left arm differ?
1) arm with shunt, IV, or history or mastectomy 2) 10-15 mm Hg
Why would you take a BP on the lower extremity and where?
When IV is in both arms and just above the posterier tibial pulse
What range is hypotensive? Signs and symptoms?
1) <90 SBP or <60 DBP 2) dizziness, fatigue, concentration problems, activity intolerance, SOA, usually sudden on set and can result in falls.
What is orthostatic/postural hypotension? (give numbers) Who is at risk for orthostatic hypotension?
1)a sudden drop in BP when moving from a lying to a sitting or standing position. decrease of 20 SBP and 10 DBP 2) elderly, people on prolongled bed rest, people on medications.
What are some causes of hypotension?
heart failure, dehydration, hemorrhage, shock
What are the three types of shock and definition?
Septic: an overwhelming infection what leads to life threatening low BP.
Anaphylactic: severe allergic reaction
What race is the highest percentage for developing hypertension? What are they also an increased risk for?
1) African American 2) death from stroke, heart disease and kidney disease
What is essential hypertension? What are some essential HTN factors?
1)Most common. caused by existing health problems and tends to develop gradually over many years. 2) family history, african american, gender, hyperlipidemia, smoking, other than 60 or post menopausal, excessive sodium and caffeine intake, over weight/obese, physical inactivity, excessive alcohol intake, low K, Ca, or Mg, and excessive or continous stress.
What is secondary HTN?
Caused by a specific disease state, tends to appear suddenly and causes higher BP than primary hypertension. ex: CHF
What are some secondary HTN factors?
kidney disease, primary aldosteronism, cushing's disease, contraction of the aorta, brain tumors, encephalitis, pregnancy, drugs
What is a hypertensive crisis? What are symptoms?
1) either systolic is greater than 180 or diastolic is greater than 120 2)severe headaches, dizziness, blurred vision, SOA, severe anxiety, and epistaxis.
What are some blood pressure meds? (class)
Diuretics, calcium channel blockers, ace inhibitors, ARBs and Beta Adrenergic
What are some nursing interventions for HTN?
monitor VS, monitor activity tolerance, measure I and Os, daily weights, collect and assess labs (BUN, creatinine, electrolytes, hemocrit, hemocrait, lipids), administer meds properly.
Semi fowlers, O2, IV fluid slowly, IV beta blockers or nicardipine. monitor BP q 15min until diastolic is below 90 but not less than 75 and then do BP q 30 min. monitor for seizures, numbness, weakness, tingling, dysrhythmias or chest pain.
What are some complications of HTN?
heart failure, atherosclerosis(hardening and thickening of arteries) and aneurysm
What should you teach the patient about BP?
self monitoring of BP, stress management, diet changes, exercise, smoking cessation, limit alcohol, sodium and caffeine intake, take meds are prescribed, know risks with medications.