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NR 667 VISE Assignment _ final questions and answers graded A+.pdf
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8/24/24, 6:01 PMNR 667 VISE Assignment
Jeremiah
Practice questions for this set
Terms in this set (271)
-No known cause in 90% of cases of primary HTN
-Secondary causes: renal failure, kidney disease, renal artery stenosis, Cushing
Etiology: Hypertension syndrome, hyper/hypo thyroidism, increased ICP, sleep apnea, oral contraceptives,
steroids, cocaine, NSAIDs, decongestants, sympathomimetics, alcohol, antidepressants,
NR 667 VISE Assignment
caffeine
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-Modifiable: smoking, DM, high cholesterol, obesity (single most important factor in
children), physical inactivity, poor diet, excessive sodium intake, excessive alcohol
Risk Factors: Hypertension consumption
-Non-modifiable: CKD, family hx, increased age (>55 men, > 65 women), low
socioeconomic status, low educational status, male sex, OSA, stress, pregnancy
-Most are asymptomatic; occipital headache, headache upon waking, blurry vision,
Assessment: Hypertension fundoscopic exam (AV nicking, exudates, papilledema), left vent. hypertrophy,
pregnancy w/HTN and proteinuria, edema, and excessive weight gain
Differential Diagnosis: Hypertension -Secondary HTN, white coat HTN (artificial elevation d/t medical environment anxiety)
-Urinalysis = proteinuria
-Electrolytes, creatinine, calcium
-Fasting lipid profile and BS
Final Diagnosis: Hypertension
-ECG
-Measure BP twice, 5 mins apart
-Patient should be seated; use proper cuff size and application
-Maintaining healthy weight and BMI
-Smoking cessation
-Regular aerobic exercise
Prevention: Hypertension -Alcohol in moderation (< 1 oz/day)
-Stress management
-Medication compliance
-Assess for and treat OSA
-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+
Non-pharm management: Hypertension -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
-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
Pharmacological management: -African Americans: 2+ medications recommended; thiazide and CCBs are the most
Hypertension 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
-Can use beta blockers (labetalol), methyldopa, CCBs (nifedipine)
Pregnancy considerations: Hypertension
-AVOID ARBs and ACEIs
-Inquire about adherence and any side effects
Follow-up: Hypertension
-Reassess monthly until patient reaches goal, then every 3-6 months as needed
-Only 54% of treated patients are at goal treatment; expect complications if under
Expected course: Hypertension treated
-Most patients require more than one medication to reach goal bp
-Stroke, CAD, MI, renal failure, heart failure, eclampsia (seizures), pulmonary edema,
Possible Complications: Hypertension
hypertensive crisis, hypertensive retinopathy, ED
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