Exam (elaborations)
NR 667 questions with correct answer1
- Course
- Institution
NR 667 questions with correct answer1
[Show more]
Content preview
NR 667 questions with correct answersEtiology: Hypertension Correct Answer--No known cause in 90% of
cases of primary HTN
-Secondary causes: renal failure, kidney disease, renal artery stenosis,
Cushing syndrome, hyper/hypo thyroidism, increased ICP, sleep apnea,
oral contraceptives, steroids, cocaine, NSAIDs, decongestants,
sympathomimetics, alcohol, antidepressants, caffeine
Risk Factors: Hypertension Correct Answer--Modifiable: smoking, DM,
high cholesterol, obesity (single most important factor in children),
physical inactivity, poor diet, excessive sodium intake, excessive alcohol
consumption
-Non-modifiable: CKD, family hx, increased age (>55 men, > 65
women), low socioeconomic status, low educational status, male sex,
OSA, stress, pregnancy
Assessment: Hypertension Correct Answer--Most are asymptomatic;
occipital headache, headache upon waking, blurry vision, fundoscopic
exam (AV nicking, exudates, papilledema), left vent. hypertrophy,
pregnancy w/HTN and proteinuria, edema, and excessive weight gain
Differential Diagnosis: Hypertension Correct Answer--Secondary HTN,
white coat HTN (artificial elevation d/t medical environment anxiety)
Final Diagnosis: Hypertension Correct Answer--Urinalysis = proteinuria
-Electrolytes, creatinine, calcium
-Fasting lipid profile and BS
,-ECG
-Measure BP twice, 5 mins apart
-Patient should be seated; use proper cuff size and application
Prevention: Hypertension Correct Answer--Maintaining healthy weight
and BMI
-Smoking cessation
-Regular aerobic exercise
-Alcohol in moderation (< 1 oz/day)
-Stress management
-Medication compliance
-Assess for and treat OSA
Non-pharm management: Hypertension Correct Answer--Stage 1: Risk
score < 10% =lifestyle modification
-Stage 2: lifestyle + medication
-DASH eating plan: high fruit, veggies, grains; low fat dairy, fish,
poultry, beans, nuts
-Reduce dietary sodium to 2,300mg/day, increase K+
-Reduce sat. fat intake
-Body weight reduction; 1kg of weight reduction = 1 mm/hg bp
reduction
-150 mins of aerobic exercise and/or 3 sessions of isometric resistance
per week
-Treat other underlying diseases
,-Check bp 2x/week during pregnancy
Pharmacological management: Hypertension Correct Answer--Start
medication for primary prevention of CVD if pt. has ASCVD risk ≥ 10%
and stage 1 HTN or if ASCVD is < 10% with bp >140/90
-Stage 2: start 2 bp-lowering medications
-African Americans: 2+ medications recommended; thiazide and CCBs
are the most effective
*DO NOT use ACE and ARB concurrently
-Beta blockers are NOT first line
-Thiazides, CCBs, ACEIs, and ARBs can be used alone or in combo
Pregnancy considerations: Hypertension Correct Answer--Can use beta
blockers (labetalol), methyldopa, CCBs (nifedipine)
-AVOID ARBs and ACEIs
Follow-up: Hypertension Correct Answer--Inquire about adherence and
any side effects
-Reassess monthly until patient reaches goal, then every 3-6 months as
needed
Expected course: Hypertension Correct Answer--Only 54% of treated
patients are at goal treatment; expect complications if under treated
-Most patients require more than one medication to reach goal bp
, Possible Complications: Hypertension Correct Answer--Stroke, CAD,
MI, renal failure, heart failure, eclampsia (seizures), pulmonary edema,
hypertensive crisis, hypertensive retinopathy, ED
Etiology: Hyperlipidemia Correct Answer--Inherited disorder, high
dietary intake, obesity, sedentary lifestyle, DM, hypothyroidism,
anabolic steroid use, hepatitis, cirrhosis, uremia, nephrotic syndrome,
stress, drug-induced (thiazide diuretics, beta blockers, cyclosporine),
alcohol, caffeine, metabolic syndrome
Risk factors: Hyperlipidemia Correct Answer--Family history, physical
inactivity, smoking, age (men > 45, women > 55 or premature
menopause without estrogen replacement), obesity, diet high in sat. fat,
DM
Assessment findings: Hyperlipidemia Correct Answer--Few physical
findings; xanthomata (fat deposits in the skin), xanthelasma (yellow
plaques on the eyelid), corneal arcus prior to age 50 (arc of cholesterol
around the iris), bruits, angina pectoris, MI, stroke
Differential diagnosis: Hyperlipidemia Correct Answer--Secondary
causes: hypothyroidism, pregnancy, DM, non-fasting state
Final diagnosis: Hyperlipidemia Correct Answer--Fasting lipid profile:
9-12 hours
-Glucose level
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller cracker. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
67096 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now