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Hypertension

Hypertension. “the silent killer”. Regulation of Blood Pressure Arterial baroreceptor system Regulation of body fluid volume Renin-angiotensin-aldosterone system Vascular autoregulation. Essential Hypertension No known cause Associated risk factors 1. Age >60, family history

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Hypertension

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  1. Hypertension “the silent killer”

  2. Regulation of Blood Pressure Arterial baroreceptor system Regulation of body fluid volume Renin-angiotensin-aldosterone system Vascular autoregulation

  3. Essential Hypertension No known cause Associated risk factors 1. Age >60, family history 2. Excessive calorie consumption, physical inactivity 3. Excessive alcohol intake 4. Hyperlipidemia 5. African ethnicity 6. High intake salt/caffeine 7. Reduced intake of potassium/calcium/magnesium 8. Obesity, smoking, stress

  4. Risk FactorsModifiable & Non-modifiable

  5. Vessel Wall Build-up

  6. Complications of Hypertension Myocardial infarction Cerebrovascular accident Peripheral vascular disease Renal failure

  7. Lifestyle Interventions Hypertension Sodium restriction Heart healthy diet Moderation of alcohol intake Exercise Relaxation techniques Smoke cessation Drug therapy

  8. Sodium Restriction

  9. Heart Dealthy Diet

  10. Moderation of Alcohol

  11. Exercise

  12. Relaxation Techniques

  13. Quit smoking

  14. Supporting Smokers Who Want to Quit • 70% of smokers want to quit • 1/3 make a serious quit attempt each year • There are effective treatments • Nurses play a significant role in smoke cessation support

  15. Nicotine Addiction • Smokers are rapidly addicted to nicotine • 7 of 10 adults regret smoking and would like to stop (70%) • 98% relapse in one year in not “program” • It takes 14-20 seconds for heroin to reach addiction centers when given IV • It takes 7-10 seconds for nicotine to reach addiction centers when smoked

  16. Immediate and long term benefits of quitting

  17. Pharmacological Methods • Nicotine replacement therapy (NRT) • Gum • Patch • Inhaler • Bupropion (Zyban) • Varenicline (Champix)

  18. A slip is not a fall! Advise to the client: • Treat it like an emergency – get away from the trigger, get rid of the smokes • Think about what happened, what went wrong and identify the triggers • Remember the signs next time • Feel good about how far you have come, picture yourself a non-smoker

  19. Diuretics Beta-adrenergic blocking agents Calcium channel-blocking agents Angiotensin-converting enzyme inhibitors (ACE inhibitors) Angiotensin II receptor antagonists (ARB) Central alpha agonists Vasodilators Alpha-adrenergic receptor agonists Drug Therapy Hypertension

  20. Drug Therapy (related) • Statins • Anticoagulants

  21. Secondary Hypertension Related to specific disease states and medications Diseases: Medications:

  22. Secondary Hypertension Clinical manifestations 1. Symptomless 2. Headaches, dizziness, fatigue 3. Vascular changes in the retina 4. Abdominal bruits 5. Tachycardia 6. Sweating/pallor 7. Delayed/absent femoral pulses Nursing diagnosis 1. Deficient knowledge 2. Risk for ineffective therapeutic regimen management 3. Ineffective tissue perfusion

  23. Malignant Hypertension Severe elevated B/P Rapidly progressive Symptoms: 1. Morning headaches 2. Blurred vision 3. Dyspnea/uremia 4. Diastolic B/P >150 mm Hg (130 mm Hg) 5. Untreated = renal failure, left ventricular failure, stroke

  24. Hypotension/Shock • Stages of shock

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