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Nursing 210 Advanced Cardiac UNIT 2

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

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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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