Hypertension
Med Surg: Cardiac
Pathophysiology
Numbers to know:
Hypertension is chronic high blood pressure, which if not
treated can cause damage to organs from all that
high pounding pressure
• Brain - CVA (stroke risk!) NCLEX TIP
• Heart - MI (heart attack) & HF (heart failure)
• Kidney - CKD (Renal failure)
• Blood vessels - Atherosclerosis (scared arteries)
• Eyes - Blindness (Retinopathy NCLEX TIP
MEMORY TRICK
Systolic/Diastolic
‘’San/Diego’’
Squeeze/Decompress
STAGE 2: 140/90 (or more)
“NORMAL BP”
STAGE 1: 130-139/80-89
ELEVATED: 120-129/80
OVER
(or less)
140/90
NORMAL: 120/80 (or less)
Signs & Symptoms NO SYMPTOMS = Silent KILLER
A –Achy head (Headache) NCLEX TIP
B –Blurred vision (retinopathy)
C –Chest pain (angina)
SEVERE: HTN Crisis OVER 180/120
Immediate Action:
• B - Beta blockers “Blocks Beats”
• C - CCBs “C Calms the heart”
• D - Dilators (Vasodilators) “Nitro = Pillow”
• E - Emergency to ICU!
OH LORDY!
LOW: 90/60 (or less)
Labs
BNP - B-type Natriuretic Peptides
• 100 & Less = Normal
• 300+ Mild
• 600+ Moderate
• 900+ SEVERE
Cholesterol Panel
• Total Cholesterol = 200
• Triglycerides = 150
• LDL = Under 100
• HDL = OVER 40
NOTE: All should be low, except the HDL
“Happy - keep them HIGH”
Imaging
• Echocardiogram measure
Ejection fraction (blood pumped out of heart)
55 - 70% = normal
Less than 40% = Heart Failure
• ECG & EKG - Tall R peaks from the high pumps
• Side note: 3 BP measurements - 1 week apart,
confirms diagnosis
Pharmacology
Blood Pressure Lowering Drugs ABCD
A –Ace inhibitors -pril Lisinopril
B
Education
DIET LOW SCC (Sodium, Calories, Cholesterol)
REDUCE ALCOHOL & CAFFEINE
C
EXERCISE: WALKING (30 min. x 5 days/wk)
D
STOP SMOKING & ALCOHOL
STRESS REDUCTION
D
Causes
SODA
S –Stress, Smoking, Sedentary Lifestyle
O–Obesity, Oral Contraceptives (birth control)
D–Diet (High sodium & cholesterol)
Diseases
DM, Renal disease, HF, Hyperlipidemia (Over 200)
A–African men & Age (old)
A–Angioedema
C–Cough
E–E+ imbalances (LOW sodium, HIGH potassium)
ARBS “-sartan” Losartan
–Beta blockers (slows HR) “-lol” Atenalol
Blocks Beats
Caution: 4 B’s
Bradycardia (60 or Less)
Bottomed out BP (80/60)
Breathing problems (COPD, Asthma)
Blood sugar masking (diabetics)
–Calcium channel blockers
Calms heart, Controls BP
Niphedipine, Cardizem, Verapamil
–Diuretics
D–Drains Fluid “Diurese”
K+ Wasting–Furosemide & HCT
(caution: Low K+, Eat fruits & green leafy)
K+ Sparing–Spironolactone
(avoid Salt Substitues)
–Dilators (vasodilators) (Relieves Pressure)
Nitroglycerin = Pillow (rest & relaxed heart)
Caution: No Viagra = DEATH
AC Anti-Clogging of the arteries
A –Antiplatelet (Anti Clumping)
C
A–ASA
C–Clopidogrel Caution: Bleeding
–Cholesterol Lowering
Lovastatin “stay clean”
Caution: Liver Toxic, NO grapefruit