NCLEX Review: Hypertension

Introduction

• Presenter: Sarah from registerednursern.com
• Topics covered: Causes, nursing management, pharmacology of hypertension
• Encouragement to visit the website for a free quiz

Definition of Hypertension

• Hypertension: Resistance of blood pumping through body/arteries due to narrowing of arteries, increasing blood pressure
• Analogy: Narrowing of a water hose causing water to jet out
• Long-term effects: Wears out organs due to increased pressure

Blood Pressure Ranges

• Normal: 120/80 or less
• Pre-hypertension: 120-139 systolic / 80-89 diastolic
• Stage 1: 140-159 systolic / 90-99 diastolic
• Stage 2: >160 systolic / >100 diastolic

Affected Organs (Mnemonic: CAKE)

• C - Cardiovascular: Congestive heart failure, ventricle enlargement
• A - Brain: Stroke from artery weakening/rupture
• K - Kidneys: Renal failure, decreased perfusion
• E - Eyes: Blurry vision, retinal vessel damage

Causes of Hypertension

Risk Factors (Mnemonic: RISK FACTORS)

• R - Race: Higher risk for Black males
• I - Increased intake: Sodium or alcohol
• S - Smoking or Stress
• K - Low Potassium/Vitamin D levels: Affects sodium balance and kidney function
• F - Family history
• A - Advanced age
• C - Cholesterol: Total cholesterol >200
• T - Too much caffeine: Causes vasoconstriction
• O - Obesity: High BMI
• R - Restricting activity: Sedentary lifestyle
• S - Sleep apnea

Secondary Causes

• Pre-existing conditions: Pregnancy, Cushing syndrome, chronic renal failure, diabetes, thyroid disorders

Nursing Management

• Assessment: Regular blood pressure checks, family history, sensory changes, BMI
• Education: Importance of medication compliance, lifestyle modifications
• Symptoms: Often asymptomatic, but can include blurred vision, headaches, chest pain, nosebleeds, dizziness
• Evaluation: Monitor blood pressure, sensory changes, medication compliance

Pharmacological Management

Thiazide Diuretics

• Examples: Hydrochlorothiazide
• Action: Remove water and sodium
• Contraindications: Renal issues, lithium use
• Education: Potassium intake, photosensitivity precautions

ACE Inhibitors

• Examples: Lisinopril
• Action: Prevent vasoconstriction
• Education: Dry cough, potassium intake, compliance

ARBs (Angiotensin Receptor Blockers)

• Examples: Losartan
• Action: Block aldosterone and receptors
• Education: Similar side effects to ACE inhibitors, no dry cough

Calcium Channel Blockers

• Examples: Amlodipine
• Action: Lower heart rate, vasodilation
• Considerations: Monitor bradycardia, CHF, AV block

Beta Blockers

• Examples: Metoprolol
• Action: Block sympathetic system
• Contraindications: Asthma, COPD
• Considerations: Monitor diabetics for hypoglycemia symptoms, heart rate

Conclusion

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