NURS 341 EXAM 2 WITH SATISFIED SOLUTIONS
Risk Factors for Primary Hypertension
- Race
- Hyperlipidemia
- Smoking
- 60+ years old
- Obesity
- Sedentary lifestyle
HTN Health Promotion
- Weight reduction
- DASH Diety
- Reduce Na intake
- Increase physical activity
What is one challenge for treatment of HTN?
There is a potential for decreased adherence due to side effects of drug therapy and
necessary changes in lifestyle. People often don't feel immediate adverse effects when
they forget to follow their drug regimen.
Common Drug Therapy for HTN
- Diuretics (spironolactone, furosemide, hydrochlorothiazide)
- Beta blockers (-lols)
- Calcium channel blockers (verapamil, diltiazem, -pines)
- ACE inhibitors (-prils)
- Angiotensin II Receptor Blockers (-tans)
Arteriosclerosis
Thickening or hardening of arterial wall; often associated with aging
Atherosclerosis
A type of arterioslcerosis involving formation of plaque within arterial wall; leading risk
factor for cardiovascular disease
Assessment for Atherosclerosis
- Assess BP bilaterally
- Palpate carotid arteries separately
- Cap refill
- Auscultate for bruits
- Cholesterol and triglyceride screenings
,Desired BP values for people older and younger than 60
Over 60 years: 150/90
Younger than 60 years: 140/90
Anyone with BPs above these goals should be treated with drug therapy and lifestyle
modifications
Mechanisms that Influence BP
- Arterial baroreceptor system
- Regulation of body fluid volume
- RAAS System
- Vascular autoregulation (dilation and constriction)
Primary HTN
- Most common type of HTN
- Results in damage to vital organs
- Caused medial hyperplasia (thickening) of arterioles
- Risk factors include obesity, smoking, stress, and family hx
Secondary HTN
Caused by a specific disease state or drug (i.e. kidney disease, cushing syndrome,
coarctation of the aorta, pregnancy, sleep apnea, and drug use of estrogen or
glucocorticoids)
Cardiac Output
CO = SV x HR
Hypertensive Crisis
- Elevated BP that can progress rapidly with readings of 180/120 mmHg or greater
- Symptoms include morning headaches, blurred vision, dyspnea, uremia
- Increases risk for stroke; will have to insert IV for immediate medication administration
How often should people at low risk for atheroslerosis monitor their cholesterol
levels?
Every 4-6 years
What drug therapy is used to treat those at risk for atherosclerosis?
Statins (HMG-CoA reductase inhibitors)
Peripheral Artery Disease
- Systemic atherosclerosis that alters the natural flow of blood through arteries and
veins of peripheral circulation.
- Commonly happens on the lower extremities
- Staged I-IV (asymptomatic, claudication, rest pain, necrosis/ gangrene)
- Characterized by hair loss, dry, scaly, pale, or mottled skin, and thickened toenails
- Extreme cases have cool extremities, darkened skin with pallor when raised,
, dependent rubor, and muscle atrophy.
- Compare extremities bilaterally during assessment (BP differences, Ankle-brachial
index, exercise tolerance, etc.)
Interventions for Peripheral Arterial Diseiase
- Exercise and positioning
- Promoting vasodilation
- Drug therapy (anticoagulation/ antiplatelet agents)
- Percutaneous vascular intervention
- Arterial revascularization
Aortoiliac and Aortofemoral Bypass
- A surgery that requires three incisions into the abdominal cavity, helping to graft blood
past arterial blockages
- Post op care includes deep breathing, monitoring for failing graft, monitoring for
compartment syndrome (accumulation of fluids that compress arteries), and assessing
for infection
6 P's of Arterial Insufficiency
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia (coolness)
Arterial Aneurysms
- Abnormal localized dilation of an artery due to a weakened vessel wall
- Commonly happen on the aorta, clavicular arteries, or femoral arteries
- Sometimes asymptomatic; often manifest with absent pulses, cool skin, pain, and limb
ischemia;
- N/V, diaphoresis, pallor, rapid and weak pulse, or aortic regurgitation may indicate
peripheral aneurysms
- DO NOT PALPATE
- Treated by surgical repair; report sudden development of pain or discoloration of
extremity post-op
Aortic Dissection
- Diagnosis in which the arterial wall splits apart
- Manifests with sharp, tearing, ripping, or stabbing pain that moves from the point of
origin, with diaphoreisis, N/V, faintness, pallor, rapid pulse, weak pulse, apprehension,
and decrease or absence of peripheral pulses.
- Have two large-bore IVs in place for rapid blood volume administration if necessary as
well as NS and medication infusion as needed
Abdominal Aortic Aneurism (AAA)
Risk Factors for Primary Hypertension
- Race
- Hyperlipidemia
- Smoking
- 60+ years old
- Obesity
- Sedentary lifestyle
HTN Health Promotion
- Weight reduction
- DASH Diety
- Reduce Na intake
- Increase physical activity
What is one challenge for treatment of HTN?
There is a potential for decreased adherence due to side effects of drug therapy and
necessary changes in lifestyle. People often don't feel immediate adverse effects when
they forget to follow their drug regimen.
Common Drug Therapy for HTN
- Diuretics (spironolactone, furosemide, hydrochlorothiazide)
- Beta blockers (-lols)
- Calcium channel blockers (verapamil, diltiazem, -pines)
- ACE inhibitors (-prils)
- Angiotensin II Receptor Blockers (-tans)
Arteriosclerosis
Thickening or hardening of arterial wall; often associated with aging
Atherosclerosis
A type of arterioslcerosis involving formation of plaque within arterial wall; leading risk
factor for cardiovascular disease
Assessment for Atherosclerosis
- Assess BP bilaterally
- Palpate carotid arteries separately
- Cap refill
- Auscultate for bruits
- Cholesterol and triglyceride screenings
,Desired BP values for people older and younger than 60
Over 60 years: 150/90
Younger than 60 years: 140/90
Anyone with BPs above these goals should be treated with drug therapy and lifestyle
modifications
Mechanisms that Influence BP
- Arterial baroreceptor system
- Regulation of body fluid volume
- RAAS System
- Vascular autoregulation (dilation and constriction)
Primary HTN
- Most common type of HTN
- Results in damage to vital organs
- Caused medial hyperplasia (thickening) of arterioles
- Risk factors include obesity, smoking, stress, and family hx
Secondary HTN
Caused by a specific disease state or drug (i.e. kidney disease, cushing syndrome,
coarctation of the aorta, pregnancy, sleep apnea, and drug use of estrogen or
glucocorticoids)
Cardiac Output
CO = SV x HR
Hypertensive Crisis
- Elevated BP that can progress rapidly with readings of 180/120 mmHg or greater
- Symptoms include morning headaches, blurred vision, dyspnea, uremia
- Increases risk for stroke; will have to insert IV for immediate medication administration
How often should people at low risk for atheroslerosis monitor their cholesterol
levels?
Every 4-6 years
What drug therapy is used to treat those at risk for atherosclerosis?
Statins (HMG-CoA reductase inhibitors)
Peripheral Artery Disease
- Systemic atherosclerosis that alters the natural flow of blood through arteries and
veins of peripheral circulation.
- Commonly happens on the lower extremities
- Staged I-IV (asymptomatic, claudication, rest pain, necrosis/ gangrene)
- Characterized by hair loss, dry, scaly, pale, or mottled skin, and thickened toenails
- Extreme cases have cool extremities, darkened skin with pallor when raised,
, dependent rubor, and muscle atrophy.
- Compare extremities bilaterally during assessment (BP differences, Ankle-brachial
index, exercise tolerance, etc.)
Interventions for Peripheral Arterial Diseiase
- Exercise and positioning
- Promoting vasodilation
- Drug therapy (anticoagulation/ antiplatelet agents)
- Percutaneous vascular intervention
- Arterial revascularization
Aortoiliac and Aortofemoral Bypass
- A surgery that requires three incisions into the abdominal cavity, helping to graft blood
past arterial blockages
- Post op care includes deep breathing, monitoring for failing graft, monitoring for
compartment syndrome (accumulation of fluids that compress arteries), and assessing
for infection
6 P's of Arterial Insufficiency
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia (coolness)
Arterial Aneurysms
- Abnormal localized dilation of an artery due to a weakened vessel wall
- Commonly happen on the aorta, clavicular arteries, or femoral arteries
- Sometimes asymptomatic; often manifest with absent pulses, cool skin, pain, and limb
ischemia;
- N/V, diaphoresis, pallor, rapid and weak pulse, or aortic regurgitation may indicate
peripheral aneurysms
- DO NOT PALPATE
- Treated by surgical repair; report sudden development of pain or discoloration of
extremity post-op
Aortic Dissection
- Diagnosis in which the arterial wall splits apart
- Manifests with sharp, tearing, ripping, or stabbing pain that moves from the point of
origin, with diaphoreisis, N/V, faintness, pallor, rapid pulse, weak pulse, apprehension,
and decrease or absence of peripheral pulses.
- Have two large-bore IVs in place for rapid blood volume administration if necessary as
well as NS and medication infusion as needed
Abdominal Aortic Aneurism (AAA)
