ASSESSMENT
What exam can be one of the first signs of HTN?
What does MAP stand for/measure?
MAP = mean arterial pressure
Avg pressure in patients arteries
Give an example of an ARB med.
What does an ARB do?
Valsartan, Losartan
Blocks binding of angiotensin II
What medication is the first line of therapy?
Diuretics
What ethnicity is HTN most common in?
African Americans
What does an echocardiogram look at?
What does an ECG look at?
Valves, u/s of chest
Electrical tracing of energy through the heart
What diet types are best for these patients?
Dash diet, Mediterranean
What are the 2 types of beta blockers?
Provide an example of each
Metoprolol, atenolol
Cardioselective = Metoprolol, Atenolol
Noncardioselective = Propanolol
What medication should be avoided with gout?
Thiazides
What 2 categories of medications are not to be given together?
Why?
ACE & ARB
Increase HF
Name 5 risk factors that cause HTN.
age (w: after menopause, M: 65 increases), African America, chronic kidney disease, diabetes, excess alcohol (W: 1/day, M: 2/day), family hx, gender, obesity, hypercholesterolemia, poor diet, sedentary lifestyle, tobacco, stress, sleep apnea
Name 3 factors that determine blood pressure?
CO = cardiac output
R = resistance
Volume of blood out & how fast/minute
What systolic # should a BP med be held?
What HR should a BP med be held?
< 100
< 50/60
What medication group can cause erectile dysfunction?
Beta blockers
What is secondary HTN caused by?
renal disease, sleep apnea, pregnancy
Name 5 lab tests used to determine HTN.
Urinalysis, electrolytes, BUN, creatinine, 24 hr urine protein
Name 3 ways to get an accurate BP.
legs uncrossed, empty bladder, feet on floor & back supported for 5 mins, no talking, remove clothing, correct cuff size, support arm, artery level, take average of 2 measures, separate by 1-2 mins
What 2 diuretics pull K+ out?
What 2 diuretics are potassium sparing?
Pull out: Hydrochlorothiazide, furosemide
Sparing: Amiloride, spironolactone
What is an example of an Ace inhibitor med?
What does an Ace inhibitor do?
Lisinopril
Converts angiotensin I to II
What is the most important assessment with hypertensive crisis with IV vasodilators?
What are fast acting oral agents for hypertensive urgency?
Monitoring I&O because it's messing with cardiac fluid & how much is coming out
Captopril, labetolol, Atenolol, Clonidine (Beta Blockers, ACEs)
What are the 5 manifestations of HTN?
headache, dizziness, sleepiness, irritability, visual disturbances
Name the 5 organs damaged from uncontrolled HTN.
What are the symptoms?
kidney, eye, brain, heart (most common), peripheral vasculature
Angina, SOB, altered speech, altered vision, nosebleeds, balance problems, nocturia
What are 2 types of calcium channel blockers?
Provide an example of each.
What does it do?
Dihydropyridines, non-dihydropyridines
Dihydropyridines = amlodipine
Non-dihydropyridines = diltiazem, verapamil
Prohibits calcium ion influx
What 3 symptoms are caused by ACE inhibitors?
Hyperkalemia, cough, angioedema
What BP indicates a hypertensive emergency?
What medications are given?
> 180/120
Nicardipine, clevidipine, labetolol, esmolol, nitroglycerin, nitroprusside