N212 - Pathophysiology Test 3 Study Guide: Hypertension & Related Conditions- Eastwick College

Hypertension • Pathophysiology • Medications/ MOA/Side effects Pathophysiology (WHY it happens) • Chronic increased systemic vascular resistance • Caused by RAAS activation, sympathetic stimulation, endothelial dysfunction • Heart pumps against higher pressure → LV hypertrophy → HF Medications (MOA + Side Effects) • ACE inhibitors (-pril): ↓ Angiotensin II → vasodilation. • Ex- Lisinopril, Enalapril ▪ SE: cough, hyperkalemia, angioedema ; HOLD IF PREGNANT • ARBs (-sartan): block Ang II receptors; Ex: Losartan, Valsartan ▪ SE: hyperkalemia, hypotension • Beta-blockers (-lol): (ALWAYS CHECK HR before giving) ↓ HR & CO , cardiac workload ; Ex: Metoprolol, Atenolol ▪ SE: bradycardia, fatigue; • Calcium channel blockers: relax vessels ; Ex: Amlodipine, Diltiazem ▪ SE: edema, constipation • WATCH B.P. • Diuretics: ↓ volume Ex: HCTZ, Furosemide ▪ SE: electrolyte imbalance ATI PRIORITY: Prevent end-organ damage (brain, kidneys, heart); Stroke Risk factors: HTN (BIGGEST), Diabetes, A-fib, Smoking, Hyperlipidemia Management & Priorities • ABCs first • CT scan BEFORE anticoagulants • Maintain BP (don’t drop too fast) • NPO until swallow study Treatment Ischemic: tPA within 3–4.5 hrs Hemorrhagic: BP control, no tPA Medication Purpose ATI PRIORITY tPA Dissolves clot Only after CT confirms ischemic Aspirin Prevents platelet aggregation Give after bleed ruled out Antihypertensives Control BP Do NOT drop BP too fast MI Key Medications MONA (Morphine, O₂, Nitroglycerin, Aspirin) Beta-blockers Anticoagulants (heparin) Labs Troponin ↑ (most specific) CK-MB ↑ BNP ↑ (if HF) Drug Why Given ATI PEARL Aspirin Prevents clot growth Give ASAP Nitroglycerin Vasodilation, ↓ preload Check BP Morphine Pain & ↓ preload Watch respirations Beta-blockers ↓ HR, ↓ O₂ demand Avoid if bradycardic Heparin Prevents clot extension Monitor aPTT Heart failure Assessment (LEFT vs RIGHT) • Left-sided: pulmonary congestion, crackles, SOB • Right-sided: peripheral edema, JVD, ascites Management: Diuretics, ACE inhibitors, Daily weights, Fluid & Na restriction ATI PRIORITY: Oxygenation & fluid balance