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Nursing 210 Advanced Cardiac UNIT 2

Hypertension is a common condition characterized by elevated blood pressure (BP) exceeding 140 mm Hg systolic or 90 mm Hg diastolic in adults, requiring three separate readings taken weeks apart for diagnosis. Clinically significant due to its potential complications affecting the heart, brain, kidneys, and more, it can be asymptomatic until damage occurs. Management entails lifestyle modifications and a step-care medication program, utilizing diuretics, beta-blockers, and other antihypertensive agents. Understanding the types of hypertension and individualizing treatment is essential for effective control and reduction of cardiovascular risk.

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Nursing 210 Advanced Cardiac UNIT 2

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  1. Nursing 210Advanced Cardiac UNIT 2 Laurie Brown RN, MSN, MPA-HA, CCRN

  2. Hypertension • “In adults, a condition in which the blood pressure (BP) is higher than 140 mm Hg systolic of 90 mm Hg diastolic on three (two) separate readings… recorded several weeks apart”. Blood Pressure = Cardiac Output x Systemic Vascular Resistance

  3. Relevance • Why is hypertension clinically significant?

  4. Procedure Take the Pulse obliteration pressure OR Known Blood Pressure • Add 20-30 mm Hg • Inflate Bp cuff to this number • Use the BELL of stethoscope take the Blood Pressure

  5. Types of Hypertension • “White Coat” Hypertension • Malignant Hypertension • Hypertensive Urgency • Pregnancy Induced Hypertension

  6. Symptoms • Often, there are no symptoms until damage has been done…

  7. Complications • Heart • Brain • Kidneys • Aorta • Arterial vessels • Eyes

  8. Medication Management Continue adding agents from other classes Referral to hypertensive specialist Step 5 Add third drug and/or substitute second drug Step 4 Add second drug or substitute another drug Step 3 Medication Diuretics or Beta-Blocker Step 2 Lifestyle modifications weight loss, diet, exercise, stop smoking, limit alcohol Step 1

  9. Causes of Resistant Hypertension • Improper BP measurement • Excessive sodium intake • Inadequate diuretic therapy • Medication • Inadequate dose • Drug actions and interactions • Smoking

  10. Lifestyle modifications • Weight reduction • DASH eating plan • Dietary sodium restriction • Aerobic physical activity • Moderation of alcohol consumption • Cessation of smoking

  11. Medications Classifications and Action • Diuretics • Alpha Adrenergic Blockers • Beta Adrenergic Blockers (olol) • Calcium Antagonist (ipine) • ACE Inhibitor (pril) • Angiotensin II Antagonist (Receptor blockers or ARB’s) (sartan) • Vasodilator

  12. BP = CO x SVR

  13. Treatment Program Individualized Step-Care Therapy for Hypertension

  14. EKG Review • Analyze this EKG • What medical orders do you anticipate?

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