NURS 251 Portage Study Guide 5
x x x x x x
x
Two xfactors xthat xdetermine xa xperson's xblood xpressure x- xCardiac xOutput xand
xSystemic x
x
Vascular
xResistance
x
Cardiac xoutput x- xamount xof xblood xejected xfrom xthe xheart's xleft xventricle xin xone
xminute x
x
(heart xrate xx xstroke
xvolume)
x
SVR x(systemic xvascular xresistance) x- xamount xof xresistance xto xblood xflow x
x
Contributing xfactors xto xa xpatient's xblood xpressure x- xCardiac xFactors: xheart xrate,
xcontractibility x
Circulating xVolume: xsalt, xalaosterone, xhormones, xand xperipheral xsympathetic
xreceptors x
x
Hypertension xClassification x- xNormotensive x= x<120/80 x
Prehypertensive x= x120-139/80-89 x
Hypertensive x= x>140/90 x
Stage x1 x= x140-159/90-99 x
Stage x2 x= x>160/100 x
x
How xto xtake xblood xpressure x- xThe xinstrument xused xis xcalled xa
xsphygmomanometer. xThe xhealth xcare xprovider xuses xa xblood xpressure xcuff xto xcut
xoff xthe xblood xflow xfrom xthe xbrachial xartery. xAs xthey xrelease xthe xpressure xin xthe
xcuff, xusing xa xstethoscope, xthey xare xlistening xfor xthe xfirst xsound, xcalled xthe
xKorotkoff xsound, xmeaning xthere xis xno xlonger xenough xpressure xto xkeep xall xthe
xblood xfrom xflowing. xThis xis xthe xtop xnumber xor xsystolic xvalue xof xthe xpatient's
xblood xpressure. xThe xprovider xcontinues xto xlet xair xout xof xthe xcuff xand xeventually
xthe xsounds xdisappear, xrepresenting xthat xthe xbrachial xartery xis xnow xcompletely
xopen. xThis xis xknown xas xthe xdiastolic xvalue xor xbottom xnumber xin xa xpatient's
xblood xpressure. x
x
Differentiate xessential xhypertension xand xsecondary xhypertension x- x-Essential
xhypertension x(primary xhypertension): xcause xof xthe xincreased xblood xpressure xis
xunknown. x x
-Secondary xhypertension: xelevated xblood xpressure xis xcaused xby xanother xdisease.
x
x
peripheral xresistance x- xresistance xgenerated xby xthe xflow xof xblood xthrough
xthe x
x
arteries. xWhen xthis xhappens, xthe xkidney xreleases xan xenzyme xcalled
xrenin.
x
Renin xenzyme x- xleads xto xfurther xvasoconstriction, xwater xand xsodium xretention,
xand x
x
an xincrease xin xblood
xpressure
x
, What xhappens xto xthe xperipheral xresistance xduring xhigh xblood xpressure x- xthere
xis xan x
x
increased xperipheral xresistance xwhich xdecreases xblood xsupply xto xthe
xkidney.
x
Antihypertensive xtherapy x- x-goal xis xto xdecrease xmorbidity xand xmortality
xwithout x
x
decreasing xquality xof
xlife
x
Antihypertensive xtherapy xshould xbe xstarted xin xpatients x- x· x60+ xif xtheir xblood
xpressure x>150/90mm/Hg. x
· x59- xor xthose xwith xchronic xkidney xdisease xor xdiabetes xused xwhen xthe xblood
xpressure x>140/90mm/Hg. x
x
The xfour xfirst xline xantihypertensives x- x-Thiazide
xdiuretics
x
-ACE-Inhibitors
x
-ARBs x
-
CCBs
x
Thiazide xDiuretics x(mechanism xof xaction x& xexample) x- x- xknown xas xa xlow xsodium
xdiet
x
- xdecreases xplasma xand xextracellular xfluid xvolumes xwhich xdecreases xpreload
xand
x
leads xto xa xdecrease xin xcardiac xoutput xand xtotal xperipheral
xresistance.
x
-
xHydrochlorothiazide
x
ACE xInhibitors x(mechanism xof xaction x& xexample) x- x- xPrevent xangiotensin xI xfrom
xbeing x
x
converted xto xangiotensin xII. xAngiotensin xII xis xa xpotent xvasoconstrictor. xIt
xalso
stimulates xthe xreabsorption xof xwater xand xsodium xinto xthe xbody. xBoth xof xthese
xactions
x
raise xblood xpressure. xTherefore, xby xblocking, xblood xpressure xis
xreduced.
x
- xLisinopril
x(Prinivil)
x
ARBs x(mechanism xof xaction x& xexample) x- x- xBlock xthe xbinding xof xAngiotensin xII xto
xtype x1 xAngiotensin xII xreceptors. xThis xblocks xvasoconstriction xand xthe xsecretion xof
xaldosterone. xAldosterone xcauses xsodium xand xwater xto xbe xreabsorbed xinto xthe
xbody, xwhich xcan xraise xBP. xTherefore, xby xblocking xthis xreceptor, xblood xpressure xis
xreduced. x- xLosartan x(Cozzar) x
x
CCBs x(mechanism xof xaction x& xexample) x- x- xBlocks xCalcium xfrom xbinding xto
xreceptors x
x x x x x x
x
Two xfactors xthat xdetermine xa xperson's xblood xpressure x- xCardiac xOutput xand
xSystemic x
x
Vascular
xResistance
x
Cardiac xoutput x- xamount xof xblood xejected xfrom xthe xheart's xleft xventricle xin xone
xminute x
x
(heart xrate xx xstroke
xvolume)
x
SVR x(systemic xvascular xresistance) x- xamount xof xresistance xto xblood xflow x
x
Contributing xfactors xto xa xpatient's xblood xpressure x- xCardiac xFactors: xheart xrate,
xcontractibility x
Circulating xVolume: xsalt, xalaosterone, xhormones, xand xperipheral xsympathetic
xreceptors x
x
Hypertension xClassification x- xNormotensive x= x<120/80 x
Prehypertensive x= x120-139/80-89 x
Hypertensive x= x>140/90 x
Stage x1 x= x140-159/90-99 x
Stage x2 x= x>160/100 x
x
How xto xtake xblood xpressure x- xThe xinstrument xused xis xcalled xa
xsphygmomanometer. xThe xhealth xcare xprovider xuses xa xblood xpressure xcuff xto xcut
xoff xthe xblood xflow xfrom xthe xbrachial xartery. xAs xthey xrelease xthe xpressure xin xthe
xcuff, xusing xa xstethoscope, xthey xare xlistening xfor xthe xfirst xsound, xcalled xthe
xKorotkoff xsound, xmeaning xthere xis xno xlonger xenough xpressure xto xkeep xall xthe
xblood xfrom xflowing. xThis xis xthe xtop xnumber xor xsystolic xvalue xof xthe xpatient's
xblood xpressure. xThe xprovider xcontinues xto xlet xair xout xof xthe xcuff xand xeventually
xthe xsounds xdisappear, xrepresenting xthat xthe xbrachial xartery xis xnow xcompletely
xopen. xThis xis xknown xas xthe xdiastolic xvalue xor xbottom xnumber xin xa xpatient's
xblood xpressure. x
x
Differentiate xessential xhypertension xand xsecondary xhypertension x- x-Essential
xhypertension x(primary xhypertension): xcause xof xthe xincreased xblood xpressure xis
xunknown. x x
-Secondary xhypertension: xelevated xblood xpressure xis xcaused xby xanother xdisease.
x
x
peripheral xresistance x- xresistance xgenerated xby xthe xflow xof xblood xthrough
xthe x
x
arteries. xWhen xthis xhappens, xthe xkidney xreleases xan xenzyme xcalled
xrenin.
x
Renin xenzyme x- xleads xto xfurther xvasoconstriction, xwater xand xsodium xretention,
xand x
x
an xincrease xin xblood
xpressure
x
, What xhappens xto xthe xperipheral xresistance xduring xhigh xblood xpressure x- xthere
xis xan x
x
increased xperipheral xresistance xwhich xdecreases xblood xsupply xto xthe
xkidney.
x
Antihypertensive xtherapy x- x-goal xis xto xdecrease xmorbidity xand xmortality
xwithout x
x
decreasing xquality xof
xlife
x
Antihypertensive xtherapy xshould xbe xstarted xin xpatients x- x· x60+ xif xtheir xblood
xpressure x>150/90mm/Hg. x
· x59- xor xthose xwith xchronic xkidney xdisease xor xdiabetes xused xwhen xthe xblood
xpressure x>140/90mm/Hg. x
x
The xfour xfirst xline xantihypertensives x- x-Thiazide
xdiuretics
x
-ACE-Inhibitors
x
-ARBs x
-
CCBs
x
Thiazide xDiuretics x(mechanism xof xaction x& xexample) x- x- xknown xas xa xlow xsodium
xdiet
x
- xdecreases xplasma xand xextracellular xfluid xvolumes xwhich xdecreases xpreload
xand
x
leads xto xa xdecrease xin xcardiac xoutput xand xtotal xperipheral
xresistance.
x
-
xHydrochlorothiazide
x
ACE xInhibitors x(mechanism xof xaction x& xexample) x- x- xPrevent xangiotensin xI xfrom
xbeing x
x
converted xto xangiotensin xII. xAngiotensin xII xis xa xpotent xvasoconstrictor. xIt
xalso
stimulates xthe xreabsorption xof xwater xand xsodium xinto xthe xbody. xBoth xof xthese
xactions
x
raise xblood xpressure. xTherefore, xby xblocking, xblood xpressure xis
xreduced.
x
- xLisinopril
x(Prinivil)
x
ARBs x(mechanism xof xaction x& xexample) x- x- xBlock xthe xbinding xof xAngiotensin xII xto
xtype x1 xAngiotensin xII xreceptors. xThis xblocks xvasoconstriction xand xthe xsecretion xof
xaldosterone. xAldosterone xcauses xsodium xand xwater xto xbe xreabsorbed xinto xthe
xbody, xwhich xcan xraise xBP. xTherefore, xby xblocking xthis xreceptor, xblood xpressure xis
xreduced. x- xLosartan x(Cozzar) x
x
CCBs x(mechanism xof xaction x& xexample) x- x- xBlocks xCalcium xfrom xbinding xto
xreceptors x
