hypertension
specialized nerve cells called ___ are found in the carotid arteries and arch of the aorta
baroreceptors
the hemodynamic hallmark of hypertension a consistent increase in ___
a. CO
b. SVR
c. SBP
b. SVR
what is a major contraindication of a nonselective beta blocker?
asthma
what type of lipids are good?
what level of LDLs put a person as risk for CAD?
<130
you should take fibric acid derivatives and ___ with caution because of the risk of myopathy
statins
** can also increase the risk for bleeding in patients taking warfarin
** increased risk of hypoglycemia in patients taking Prandin
the kidneys contribute to BP regulation by controlling __ excretion and ___ volume
sodium; ECF (extracellular fluid)
hypertension can cause Nephrosclerosis (chronic kidney disease), what are some indicative lab values you might see for this?
albuminuria, proteinuria, microscopic hematuria, high serum creatine, elevated BUN
common side effects of antihypertensive drugs:
orthostatic hypertension, loss of libido, ED, dry mouth and frequent voiding (diuretics)
what the modifiable risk factors for CAD?
high serum levels, obesity, lack of physical activity, hypertension, tobacco use, diabetes, metabolic syndrome, psychologic states (type A), homocysteine, substance use
T/F
Chronic angina is usually received with rest
TRUE
a patient comes into the ED with a blood pressure of 115/86, which classification of hypertension would this be?
stage 1
for active people, BP is highest in the ___, decreases during the ___, and is lowest at ___
patients with hypertension usually do not show a nocturnal dip in BP, they are called ____
patients at the highest risk for CVD are called ____, these patients have an increase in nighttime SBP
nondippers
reverse dippers
if bilateral bp measurements aren't equal, which arm would you tell the patient to use for future measurements?
the arm with the highest BP reading
table 33.5
track your weight, physical activity, and calorie intake
prepare and eat smaller, more frequent meals
use fresh or frozen veggies instead of canned
use liquid vegetable oils instead of solid fats
What 2 things are you most likely going to see on a EKG when monitoring a patient with silent ischemia
ST depression and T wave inversion
what are some contributing factors associated with PRIMARY hypertension?
elevated lipid levels, ethnicity (blacks are at a higher risk), gender (men), sedentary lifestyle, stress, increased sodium intake, obesity, age, family history, diabetes, tobacco use, and excessive alcohol intake
table 32.4
what are the AHA's life simple 7 steps?
1. manage blood pressure
2. control cholesterol
3. reduce blood sigar
4. get active
5. eat better
other modifications: restrict sodium intake and alcohol
6. lose weight
7. stop smoking
what types of activities/things should you tell your patient to avoid when taking vasodilation drugs?
avoid hot baths/saunas, excessive amounts of alcohol, strenuous activities
the most widely used lipid lowering drugs:
what are some adverse effects with these drugs?
HMG- CoA reductase inhibitors ("statin")
liver damage, myalgia --> rhabdomyolysis
** signs are increased creatine kinase levels and muscle pain (usually occurs when taken with fabric acids such as niacin)
what does PQRST stand for when assessing a person for angina?
Precipitating events
Quality of the pain
Region and radiation of pain
Severity of pain
Timewhat are some common causes of secondary hypertension?
cirrhosis, oral contraceptives, NSAIDS, SNS stimulants (cocaine, MAOIS), Cushing syndrome, brain injury/tumor, renal disease, sleep apnea
table 32.3
what are some foods you would encourage your patient to eat on the DASH diet?
fruits, veggies, fat free/low fat milk dairy products, whole grains, fish, poultry, nuts
what is the recommended amount of sodium intake for a person with hypertension or at risk?
name some of the foods to avoid on the Salty Six list
less than 1500 mg/day
bread, pizza, soup, cured meats (pepperoni, bacon)
** read labels (ex: toothpaste w/ baking soda)
common side effect of Niacin to warn your patient about:
what is an intervention that could help with this side effect?
flushing of the skin
take an NSAID or aspirin 30 minutes prior
what are you going to see on the EKG with a patient experiencing Prinzmetals Angina?
when does type of angina usually occur? what can be done to help?
ST segment elevation
at rest; moderate exercise, nitroglycerin tablets, CCB, rest, may disappear spontaneously (pg 710)