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Hypertension (High Blood Pressure)
The consistent elevation of systemic arterial blood pressure.
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Drugs Ace Inhibitors Calcium Channel Blockers Adrenergic Antagonists
Enalapril (Vasotec) Calcium Channel Blockers Nifedipine (Procardia) Adrenergic Antagonists Doxazosin (Cardura) Direct Vasodilators Hydralazine (Apresoline)
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Classification Etiology: (Genetic & Environmental) Normal
119/79 or less Prehypertension 120-39/80-89 Stage I Hypertension /90-99 Stage II Hypertension 160 of higher/100 or higher Etiology: (Genetic & Environmental) Disease Drugs Diet Alcohol & Smoking
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Factors Responsible for BP
Cardiac Output –volume of blood pumped per minute Stroke Volume –amount of blood pumped by a ventricle in one contraction Peripheral Resistance –friction in the arteries (diameter) Blood Volume –amount of blood in vascular system
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Consequences Heart, Brain, Kidneys, and Retina
Heart works harder to pump blood to organs and tissues = HF Vascular System –damage blood vessels that supply blood & O2 to brain = CVA (stroke) Kidney Retina
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Nurse’s Role Vital Signs Dizziness/ Lightheaded
Labs (electrolytes –potassium) Daily weights Urinary output Lifestyle changes (diet & exercise) Safety Education
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Prototype Drugs Ace Inhibitors Calcium Channel Blockers
Enalapril (Vasotec) Calcium Channel Blockers Nifedipine (Procardia) Adrenergic Antagonists Doxazosin (Cardura) Direct Vasodilators Hydralazine (Apresoline)
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Heart Failure Inability of the ventricles to pump enough blood to meet the body’s metabolic demands
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Drugs ACE Inhibitor & Angiotensin receptor blocker Diuretics
Lisinopril (Prinivil) Diuretics Cardiac Glycosides Digoxin Beta-adrenergic blockers metoprolol
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Blood Circulation
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Heart Failure Contractility –strength of contraction of heart
Inotropic effect –change in contractility of heart Positive inotropic Negative inotropic
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Heart Failure Cardiac output –amt of blood pumped by each ventricle per minute Preload –degree of which myocardial fibers stretched prior to contraction Afterload –degree of pressure in aorta that must be overcome for blood to be ejected from left ventricle
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Symptoms Associated with HF
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Nurse’s Role Vital Signs Dizziness/ Lightheaded
Apical Pulse Dizziness/ Lightheaded Labs (electrolytes –potassium) Daily weights Urinary output Lifestyle changes (diet & exercise) Safety Education Documentation
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HEART FAILURE Drugs ACE Inhibitor & Angiotensin receptor blocker
Lisinopril (Prinivil) Diuretics Cardiac Glycosides Digoxin Beta-adrenergic blockers metoprolol
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Angina Pectoris & Myocardial Infarction (MI)
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Drugs Nitrates Beta Blockers Calcium Channel Blockers Thrombolytics
Nitroglycerin Beta Blockers Atenolol (Tenormin) Calcium Channel Blockers Diltiazem (Cardizem) Thrombolytics reteplase
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Pathophysiology of MI Plaque build up narrow branches of coronary arteries pieces of unstable plaque break off & lodge in small vessels of heart plaque activates coagulation cascade causing clot obstruction of vessel inability for blood flow deprived O2 to heart ischemia death of muscle cells
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Factors Affecting Myocardial Oxygen Supply & Demand
Physical exertion Emotional excitement Narrowed coronary arteries
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Nurse’s Role Vital Signs –Cardiac monitoring
Frequent physical assessment (neuro/cardiac/respiratory) Dizziness/ Lightheaded Labs (electrolytes –potassium) Daily weights Urinary output Lifestyle changes (diet & exercise) Safety Education
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Angina and Myocardial Infarct Drugs
Nitrates Nitroglycerin Beta Blockers Atenolol (Tenormin) Calcium Channel Blockers Diltiazem (Cardizem) Thrombolytics reteplase
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