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Catagories of Hypertension
- Prehypertension: 120-139/80-89
- Stage 1: 140-159/90-99
- Stage 2: 160/100
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Damage by sustained Hypertension
- Heart- works harder=heart failure
- Brain- damages vessels carrying blood and oxygen in brain can lead to TIA and CVA
- Renal Function- vascular damage in arteries of kidneys lead to progressive loss of function
- Eyes- vessels in retina can rupture or become occluded leding to visual impairment or blindness
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What lab results are most important for Diuretics and Digoxin?
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What should Asthma patients NOT take?
Betablockers
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What can happen when an ER patient comes in with really high BP and is given a vasodilator to lower it?
BP can rise due to autoresponse
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Cardia Output x Systemic vascular resistance=
Blood Pressure
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What can Beta Blockers do to heart rate?
lower it
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What is the correlation between chronic hypertension and heartfailure?
When the BP is always high, the heart works harder and gives out
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Triglycerides
- most common body fat
- work most when body needs energy
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Phospholipids
- essential to building plasma membranes
- lecithins best known
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Steroid cholesterol
- most widely known
- most widely known for role in promoting atherosclerosis
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Statins
- Report any muscle aches or weakness (can lead to rhaodomyolysis)
- give in evenings b/c cholesterol biosynthesis is higher at night.
- Lipitor, Pravachol, Crestor
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Sequestrans
- Do not give with other meds
- Give about 4 hours between meds
- often combined with statins
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Niacin
- Give aspirin 30 min b/4 to help prevent hot flashes and flushing se
- a B complex vitamin
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Angina
- steady, intense, heavy chest pains
- starved for O2
- onset by exercise, caffiene, stress, alcohol
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Heart Attack (MI)
part of the heart dies
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What can NOT be taken with erectile dysfunction meds?
Nitro
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What do you check before giving Digoxin?
Apical pulse for a full minute
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Left sided heart failure causes?
- Cough
- Trouble breathing
- fluid backup in lungs
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Right sided heart failure causes?
- Feet swelling
- Liver congestion (fills with blood, feels firm and engorged)
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Sign of toxicity from Digoxin
Neasua is the most serious se
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What do you check before giving Ace Inhibitors?
BP
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How does the diuretic HCTZ (Hydrochlorothiazide) work?
- lowers the blood volume to lower BP
- flushes all out through kidneys
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What conditions complicate taking Beta Blockers?
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What do you teach a patient about weight gain?
call Dr if gain 2lb/day or 5lb/week
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What causes dysrhythmia?
Phosodiurace inhibitors
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High risk factors for high cholesterol?
age, high lipid levels, family history
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Primary goal of Angina meds?
- Raise O2 supply
- Reduce O2 demand
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What meds lower heart rate?
- beta blockers
- calcium channel blockers
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Normal Potassium level
- 3.5-5
- call Dr if out of range (high or low) even if only a few pts
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Major SE of anti-dysrythmics
can cause other disrythmic problems
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Ace Inhibitors
- can have 1st dose phenomenon: profound hypotension
- end in PRIL
- dry cough most common se
- not for asthma or copd
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Causes of Heart Failure
- Chronic hypertension
- Mocardial infarction (MI)
- Mitral Senosis
- Valvular heart disease
- Congenital heart disease
- Aging heart
- Diabetes
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Types of Diuretics
- Loop Diuretics: (Lasix)
- Potassium Sparing Diuretic: (Spironolactone)
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Coronary Artery Disease (CAD)
- One of leading causes of mortality in US
- May be up to 50% or more occluded before any symptoms
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Streptokinase
- Clot Buster
- watch for orientation and alertness b/c could cause brain bleeding
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Signs of Bleeding
- dark tarry stool
- bleeding gums
- Petechiae (small round red spots)
- Ecchymosis (bruising)
- Purpura (lg red/purple spots)
- Vital sign changes: increased heart rate, low blood pressure, increased resp
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