Cardiovascular disorders
Terms
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- Definition of Hypertension
-
BP >140/90
In elderly >160/90 - Essential Hypertension
- -no specific cause,r/t increased peripheral resistance
- Contributing factors to HTN
- obesity, smoking, stress(stimulates nervous system to vasoconstrict), arteriosclerosis and atherosclerosis, + family hx, ^age, african american, diet ^ in salt and saturated fats.
- Regulation of BP
-
Sympathetic nervous system- Increases BP
Parasympathetic- Decreases BP
Adrenal glands- Renin-angiotension-aldosterone system - Secondary HTN
- An underlying disease or abnormality EX: Renal Abnormalities, endocrine and metablic disorders, CNS disorders, Coarctation of the aorta, pheochromocytoma
- Malignant HTN
-
Diastolic > 120 Ex: 200/122
-causes retinopothy, kidney damage, brain damage. - Hypertensive Crisis
-
BP suddenly goes up; systolic >240
-caused by stopping BP meds abruptly
-s/s CHF and CNS dysfunction; cerebral dysfunction, lethargic, N/V, convulsions - Treatment of Hypertensive Crisis
- Nitroprusside (vasodialator) and diuretics.
- HTN effects on body
- Damage to eyes, heart, kidneys, brain and abnormalities can be found on physical exam and diagnostic tests.
- HTN Mod. to severe Complications and Clinical Findings. (Prolonged ^ BP)
- Headaches, dizziness and fatigue, palpitations, nosebleeds. Retinal hemorrhage, narrowing of arterials, L ventricular enlargement, freq. urination, ^BUN, ^creatine,(r/t kidney function), ^K+
- Complications of untreated/uncontrolled HTN
- Decreased life expectancy, heart attack, blindness, kidney failure, stroke
- Medications for HTN
-
Diurectics
Vasodilators
Angiotensin-converting Enzyme Inhibitors (ACE inhibitors), Calcium Antagonists, Beta-Adrenergic Blockers - Diuretics
-
increase excretion of NA and water.(if on lasix prob on K+).
Lasix, Thiazides, K+ sparing(Aldactone). IV push can cause hearing loss, PO does not. Monitor I/O -
Beta-Adrenergic Blockers
Vasodilators -
decrease BP(inhibits sympathetic NS), also decrease pulse. Methyldopa, Propanolol, clonidine.
-acts on smooth muscles(decreases periphral resistance) Hydralazine. -
Calcium Antagonists
ACE inhibitors -
-increase CO & tissue perfusion= decreased preload and afterload resistance. Diltiazem hydrochloride, nifedipine
-ACE inhibitor; captopril