STUVIA 2024/2025
1. Science
2. Medicine
3. Cardiology
PNE 103. Ch. 27 Caring for Clients with
Hypertension. Med/Surg. Nursing 12th Ed. Timby
Blood pressure (BP)
1. The force produced by the volume of blood in arterial walls.
2. BP=CO (cardiac output) x PR (peripheral resistance.).
3. Baroreceptors and chemoreceptors, neurons in the right atrium and carotid artery above the aorta,
stimulate the brain when there is a decrease in BP or change occur in the blood levels if O2 and
carbon dioxide are sensed.
BP control mechanism/failure:
1. Baroreceptors should counteract a rise in BP but DON"T
2. Blood volume - kidneys responsible of excretion of NA/H2).
3. Renin-angiotensin/Aldosterone - inappropriate secretion of renin keeps BP high.
4. Vascular autoregulation - responsible for perfusion/unclear why it causes HTN.
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Hypertension (HTN)
abnormally high blood pressure
***NOTE: the onset of HTN, considered "the silent killer," often is gradual.
Measuring BP
1. Top number is the systolic BP
2. Bottom number is the diastolic BP
3. Normal BP for adults ranges from 100/60 to 119/79 mm Hg.
4. The autonomic nervous system, the kidneys, and various endocrine glands regulate arterial
pressure.
5. Screening of BP is an important method for identifying ppl. at risk for HF, renal failure, and stroke.
Systolic vs diastolic pressure
1. systolic = high pressure, diastolic = low pressure.
2. Systolic is a better indicator of risk of heart attack/stroke (arteriosclerosis).
Symptoms of elevated BP (malignant hypertension)
1. HA
2. blurred vision
3. DIB
4. Symptoms of decrease urine output and itchy skin (BP causes damage to kidneys)
5. Systolic greater than 200
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6. Diastolic greater than 150
Prehypertension BP
Systolic BP of 120 to 139 mm Hg and diastolic 80-89 mm Hg.
Stage 1 Hypertension
Systolic BP of 140-159 mm Hg or a diastolic BP between 90-99 mm Hg.
Stage 2 Hypertension
Systolic BP that equals or exceeds 160 mm Hg or a diastolic pressure that equals or exceeds 100
mm Hg.
Hypertensive heart disease
When elevated BP causes a cardiac abnormality, this term is used.
Hypertensive vascular disease.
When vascular damage is present without heart involvement, this term is used.
Hypertensive cardiovascular disease
When both heart disease and vascular damage accompany hypertension, this term is used.
Hypertension is divided into two main categories/risk factors:
1. Essential (primary: idiopathic)
2. Secondary
Essential hypertension
1. Most common/idiopathic
2. About 95% of cases, sustained elevated BP with no known cause.
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Risk factors: Family Hx., increase sodium intake, obesity, smoking, stress, hyperlipidemia.
Secondary hypertension
1. Elevated BP that results from or is secondary to some other disorder (renal most common).
2. Disease or medication causes increase BP.
Risk factors: Kidney disease, hyperthyroidism, Cushing syndrome, pheochromocytoma.
Hypertension effects the following organs and cause:
(Figure 27-2 p. 460)
1. Eyes: Hypertension causes ocular hypertension, rupture of ocular vessels, retinopathy, blindness.
2. Brain: Hypertension causes vascular stifling causes, narrowed lumens.
A. Narrowed lumens causes cerebral hypertension, cerebral arterial rupture, cerebral arterial
occlusion, then to a stroke.
B. Narrowed lumens causes, cerebral ischemia, cognitive impairment, the to dementia.
3. Kidneys: Hypertension causes decreased blood causes, impaired excretion, then to renal failure.
4. Heart: Hypertension causes the heart to Pump harder causes, hypertrophy, and then HF.
White-coat hypertension
A term describing elevated BP that develops during evaluation by medical personnel who traditionally
have worn a white coat.
Hypernatremia
Elevated serum sodium level, increases blood volume, which raises BP.
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