Hi, I'm Cathy with Level Up RN. In this video,
I'm going to talk about atherosclerosis as well as hypertension. And at the end of the
video, I'll give you guys a quick little quiz to test your understanding of some of the key
information I'll be covering in this video. So definitely stay tuned for that. And if you
have our medical surgical nursing flashcards, definitely pull those out so
you can follow along with me. First up, we have atherosclerosis which is
the buildup of plaque on the arterial walls, and these plaque deposits can become so large
that they impair blood flow. In addition, these plaques can rupture causing a thrombus or
embolus. So a blood clot which in turn can cause a myocardial infarction or a stroke. So risk factors
associated with atherosclerosis include older age, immobility, smoking, increased cholesterol
numbers, obesity, diabetes, as well as stress. So a patient with atherosclerosis may
have hypertension. And that makes sense, right? Because if we have these plaques in the
arterial walls, then we are narrowing the lumen of those arteries which increases blood pressure.
Also upon assessment, we may hear bruits because of that turbulent blood flow. In terms of
labs, a patient with atherosclerosis will often have elevated LDL levels as well as triglycerides.
So one key treatment for this condition would be the administration of cholesterol-lowering
medications such as statins. We also want to provide teaching to the patient, they should
quit smoking if they smoke, they should lose weight if applicable, and make sure they
exercise and consume a heart-healthy diet. Now let's talk about hypertension
which is high blood pressure. So the pathophysiology behind hypertension is
that we have increased peripheral resistance and/or increased cardiac output such that we
end up with an elevation in blood pressure. So that increased peripheral resistance may be
due to atherosclerosis which we just talked about, so that's definitely a contributing factor
in many cases for hypertension. Over time, hypertension can cause damage to the heart and
the blood vessels which places the patient at increased risk for an MI or stroke. So there
are two types of hypertension. We have primary and secondary. So with primary hypertension
which is also called essential hypertension, we have risk factors such as a family history,
increased sodium intake, as well as obesity, smoking, stress and hyperlipidemia, so
increased LDL or triglyceride numbers. With secondary hypertension, we have a medication
or disease that is causing an increase in blood pressure. So risk factors include kidney disease,
hypothyroidism, Cushing's syndrome, as well pheochromocytoma which is a tumor on the adrenal
gland that causes an increase in blood pressure. In terms of the signs and
symptoms of hypertension. In most cases, patients are asymptomatic, so they
will not have any signs and symptoms. However, if their blood pressure gets high enough, then
they may end up in a hypertensive crisis which is a complication of hypertension and they
may complain of a headache, chest pain, shortness of breath, and dizziness. So as
a nurse, you're definitely going to want to monitor your patient for those types of signs and
symptoms which can indicate a hypertensive crisis. In terms of diagnosis. We would diagnose a
patient with hypertension if their blood pressure is elevated during two or more visits. And
the level though, however, the threshold for diagnosing hypertension, really varies depending
on the source. So the American Heart Association says that a patient has stage 1 hypertension
if their systolic blood pressure is over 130 or their diastolic blood pressure is over
80. However, the Joint National Committee says that a patient will have stage 1 hypertension
if their systolic blood pressure is over 140 or their diastolic blood pressure is over 90. So
as a nursing student, you need to find out which of these sources your school uses and what source
you'll be responsible for on your nursing exams. In terms of treatment, we can provide the patient
with diuretics to try to get rid of that excess fluid which will help to decrease that cardiac
output. We can also provide the patient with antihypertensive agents such as calcium channel
blockers, beta-blockers, and ace inhibitors. And I go over all of those medications in detail
in my pharmacology playlist, so definitely check that out. We also need to provide the
patient with teaching. In terms of diet, we want the patient to consume a DASH diet which is highly
recommended for hypertension. So with a DASH diet, we encourage an increased intake of vegetables and
fruits as well as low-fat dairy. And we encourage a decreased consumption of sodium and fats,
particularly saturated fats and trans fats. We also want to encourage our patients to lose
weight if that's applicable, reduce their stress, quit smoking, limit alcohol consumption, and they also need to monitor their blood
pressure on a regular basis at home. Okay. It's time for a quiz. I have three
questions for you. The first question is a fill-in-the-blank question. A buildup of
plaque on the arterial walls is called blank. The answer is atherosclerosis. Question
number two is a true-false question. Individuals with hypertension are
typically asymptomatic. True or false? The answer is true. Question number three.
An individual with a history of hypertension complains of a headache, chest
pain, and shortness of breath. What complication does the nurse suspect?
The answer is a hypertensive crisis. Okay. That's it for this video.
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