HTN Basics
What is the normal blood pressure range for an adult?
Answer: Less than 120/80 mmHg
Which modifiable lifestyle factor is the biggest contributor to high blood pressure?
Answer: High sodium intake
What is the most common cardiovascular complication of long-term hypertension?
Answer: Left ventricular hypertrophy (heart enlargement).
Rationale: The high blood pressure forces the heart to work harder, leading to thickening and enlargement of the left ventricle.
Which class of medications is considered first-line treatment for hypertension?
Answer: Diuretics
Remember what concerns are associated with diuretics such as hypokalemia.
What is the minimum time a patient should sit before taking a blood pressure reading?
Answer: 5 minutes.
What blood pressure reading defines Stage 1 Hypertension?
Answer: 130–139 systolic OR 80–89 diastolic
Name three modifiable risk factors for hypertension.
Answer: Smoking, obesity, high-sodium diet, sedentary lifestyle, alcohol use.
Hypertension increases the risk of what two major brain-related events?
Answer: Stroke and transient ischemic attack (TIA).
Which medication can cause a persistent dry cough?
Answer: ACE inhibitors (e.g., lisinopril).
What type of diet is recommended for patients with hypertension?
Answer: DASH diet (low sodium, high potassium & fiber).
What does the slang term "silent killer" mean in relation to HTN?
Hypertension is often called the “silent killer” because it usually has no symptoms.
Rationale: The early stages of hypertension typically are asymptomatic. Symptoms might occur in stage 2 but generally when Blood pressure is significantly high.
What is the most common identifiable cause of secondary hypertension?
Answer: Kidney disease.
Rationale: Damaged kidneys struggle to remove excess fluid and sodium, leading to increased blood volume and pressure.
Name one way hypertension can damage the kidneys.
Answer: Causes chronic kidney disease (CKD) due to decreased blood flow.
What would cause the nurse to hold the client's dose of atenolol?
Answer: A HR less than 60bpm or BP less than stated parameters.
Rationale: Beta blockers decrease HR as well as BP. HR and BP must meet parameters to safely administer medication
How much sodium per day should a hypertensive patient consume?
Answer: Less than 2,300 mg (ideally less than 1,500 mg).
Name three target organs affected by long-term hypertension.
Answer: Heart, kidneys, brain, eyes (retina).
Which endocrine disorder can cause secondary hypertension?
Answer: Cushing’s syndrome or hyperaldosteronism.
How does hypertension affect the eyes?
Answer: Causes hypertensive retinopathy, leading to vision loss.
What are two major side effects of angiotensin receptor blockers?
Answer: Losartan is an angiotensin receptor blocker (ARB) for hypertension. Side effects include N/V and dizziness that is caused by temporary drops in blood pressure especially when changing positions
Why should patients taking antihypertensives be advised to change positions slowly?
Answer: To prevent orthostatic hypotension.
What is the difference between primary (essential) hypertension and secondary hypertension?
Answer: Primary hypertension has no identifiable cause and develops over time, while secondary hypertension is caused by an underlying condition (e.g., kidney disease, endocrine disorders).
What are the risk factors to hypertension and how do they contribute?
Answer: Obstructive sleep apnea; Low HDL levels; Diet: High sodium, low potassium; sedentary lifestyle; obesity
Uncontrolled hypertension can lead to an emergency condition where the heart cannot pump effectively, resulting in fluid buildup in the lungs. What is this condition called?
Answer: Heart failure (specifically, left-sided heart failure or hypertensive heart disease).
What education will the nurse provide to a client prescribed an ACE inhibitor?
Answer: Report swelling of the hands of face immediately. Monitor potassium intake. Cannot take this medication while pregnant. Monitor for orthostatic hypotension.
Rationale: ACEIs can cause angioedema which is a rare but serious complication. ACEIs can cause hyperkalemia. ACEIs generally do not affect HR.
Name three non-pharmacologic ways to lower blood pressure.
Answer: Exercise, weight loss, stress management, smoking cessation, diet changes.