MED-SURG
CARDIAC SYSTEM
Nurse
in the making
© 2020 NurseInTheMaking LLC
Nurse
in the making
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© 2020 NurseInTheMaking LLC
HYPERTENSION (HTN)
HYPERtension = HIGH BP
Most accurate diagnosis for HTN
Systolic
Diastolic
(Squeeze)
(Decompress)
Normal
< 120
< 80
Pre-htn
120 - 139
80 - 89
Stage 1 htn
140 - 159
90 - 99
Stage 2 htn
> 160
> 100
HTN crisis
> 180
congestive heart failure (chf)
affected organs
categories
Overworking of the heart muscle
(ventricle enlarges)
stroke
Weak & narrow vessels
could lead to rupture of vessels
renal failure
Too much blood flowing to the
kidneys at a fast rate & high pressure
visual changes
Damages blood vessels in the retina
(blurred vision, can’t focus on objects)
> 120
RISK FACTORS
MOST
COMMON
Primary HTN
Also called
essential or idiopathic HTN
• Cause is unknown
• Not curable, only controllable
secondary HTN
F
A
• Has a direct cause / preexisting condition
Family HX
Advanced age
↑ Cholesterol
Too much caffeine
Smoking
T
O
R
Low K+ & vitamin D levels
S
Sleep apnea
Race (African Americans)
Intake of Na/ETOH
• Chronic kidney disease
• Diabetes
• Hypo/Hyperthyroidism
• Cushing syndrome
• Pregnancy
• Certain drugs (oral contraceptives)
Obesity
Restricted activity
TAKING A PROPER
BLOOD PRESSURE
• Look for the brachial artery!
SIGNS & SYMPTOMS
Usually asymptomatic!
Commonly called the
“silent killer”
• Do not smoke, exercise, drink caffeinated
beverages or alcohol within 30 minutes
Symptoms: • Blurred vision
(if seen) • Headache
• Chest pain
• Nose bleeds
• Instruct the client to...
- Sit in a chair with legs uncrossed
- Arm at
level
- Correct size cuff
q
EDUCATION
• Limit sodium intake
• Limit alcohol intake
• Smoking cessation
• Exercise programs for
weight loss if needed
ANTIHYPERTENSIVE
MEDICATION OVERVIEW
“ ABCDD “
© 2020 NurseInTheMaking LLC
• NO BP in arms with....
Too small = false high BP
- HX mastectomy Too large = false low BP
- HX of AV shunt
- Blood clots
- Current IV in the arm
• Teach how to measure BP
& keep a record
SUFFIXES
A
B
C
D
D
ACE inhibitors
-PRIL
BETA Blockers
-OLOL
Calcium Channel Blockers -PINE -AMIL
Digoxin
Diuretics