front 1 Hypertension is known as a silent killer. Why? | back 1 It commonly has no signs or symptoms and yet is the major cause of premature death, heart failure, CVA, renal disease, and MI |
front 2 What is an elevated level of hypertension? | back 2 120-129/<80 |
front 3 What is a stage 1 level of hypertension? | back 3 130-139/80-89 |
front 4 What is a stage 2 level of hypertension? | back 4 140+/90+ |
front 5 What level is considered a hypertensive crisis? | back 5 >180/>120 |
front 6 What is hypertension based off of? | back 6 cardiac output and peripheral resistance |
front 7 What are the types of hypertension? Which one is the most common? | back 7 Primary and Secondary. Primary is the most common. |
front 8 What are some RISKFACTORs of primary hypertension? | back 8
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front 9 What is secondary hypertension? | back 9 Hypertension resulting from another underlying disease, medications, or other drugs. It will resolve once the disease is dealt with, the pt stops taking the medication, or stops doing drugs. |
front 10 What are some signs of hypertension? | back 10 CHIEF
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front 11 What are some lifestyle modifications to treat hypertension? | back 11 weight loss, DASH diet, reduce intake of sodium, increase intake of potassium, exercise, and use alcohol moderately. |
front 12 What are the ABCDs for hypertension drug therapy? | back 12 ACEI/ARBS Beta (adrenergic) Blockers Calcium channel blockers Diuretics |
front 13 What is the prototype drug for ACE? | back 13 captopril |
front 14 What do all ACE drugs end in? | back 14 "-pril" |
front 15 What are some other drugs in the ACE drug class? | back 15 lisinopril and benzapril |
front 16 What is a fun way to know what a common ACE drug symptom is? | back 16 "coughing prils" |
front 17 How do ACE drugs work? | back 17 they block the enzyme that converts angiotensin l to ll. It also inhibits the breakdown of bradykinin, prolonging vasodilating effects (thus lowering BP) |
front 18 What kind of patients would you expect to be prescribed ACE inhibitors? | back 18 pts w hypertension, DM, post MI, and to prevent/reverse heart remodeling with HF. |
front 19 What else do ACE inhibitors do in the body? | back 19 decreases pressure in kidneys (thus protecting it), decreases peripheral vascular resistance and O2 demand for the heart (thus lowering the workload for the heart). |
front 20 What are some effects of ACE inhibitors? | back 20 CAPTOPRIL
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front 21 ACE inhibitors have a BBW. What is it? | back 21 do NOT give if the pt is pregnant or trying to become pregnant. If they are in their child bearing years, make sure they use birth control. |
front 22 What are some nursing considerations when it comes to ACE inhibitors? | back 22 monitor labs/electrolytes, consult provider if pt's cough is bothersome (affecting ADLs), AVOID salt substitutes in foods already rich in K. |
front 23 What should you ABSOLUTELY NOT DO when it comes to giving ACE inhibitors? | back 23 administer with ARBS. DO NOT GIVE PTS TAKING ACE INHIBITORS ARBS. |
front 24 What kind of diuretic is also helpful in lowering hypertension? | back 24 Thiazide diuretics |
front 25 What is the prototype drug for thiazides? | back 25 hydrochlorothiazide |
front 26 How would you use hydrochlorothiazide for the treatment of hypertension? | back 26 in combination with other drugs |
front 27 How does hydrochlorothiazide work? | back 27 it decreases reabsorption of Na/Cl by inhibiting the Na/Cl channel in the distal convoluted tube. It is considered the "middle ground" for diuretics. For hypertension, the mechanism of action is unknown, but has been shown to cause vasodilation. |
front 28 What are some advantages of using thiazide diuretics? | back 28 it's cheap, relatively well tolerated, and is useful in patients with kidney stones and osteopenia. |
front 29 What are some possible side effects of thiazide diuretics? | back 29 orthostatic hypertension, HYPOnatremia, HYPERcalcemia, HYPOkalemia, HYPERuricemia, and HYPERglycemia. (aka increases Ca (in urine/blood) and glucose while decreasing Na/K) |
front 30 What are some nursing considerations when using thiazide diuretics? | back 30 monitor I/O, weight, and labs. |
front 31 What would you tell a patient for educating reasons when it comes to thiazide diuretics? | back 31 Take the medications during the day (so that pt doesn't go up to pee throughout the night), change positions frequently, get up slowly, and eat more K rich foods (like bananas, dark leafy greens like kale, spinach, etc.) |
front 32 What kind of patients would make you question the provider if they had prescribed thiazide to? | back 32 pts with a sulfa allergy and have gout |