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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher Nursing (RN) School Study Aid


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32 - Hypertension
29 Picmonics to Learn | 47 mins

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Beta-1 Receptor
Characteristics
Gs Protein Class
Increased Heart Rate
Increased Contractility
Increase Renin Release
Increased Lipolysis
43 secs
Beta-2 Receptor
Characteristics
Gs protein class
Increased Heart Rate
Increased Contractility
Increased Lipolysis
Increased Insulin
Increased Aqueous Humor Production
Ciliary Muscle Relaxation
Vasodilation
Bronchodilation
Decrease Uterine Tone
1 min
Adrenal Gland (Basic)
Characteristics
Adrenal Cortex
RAAS Stimulates Aldosterone
CRF (CRH) Acts on ACTH Receptors
Cortisol Released
Androgens Released
Adrenal Medulla
Epinephrine & Norepinephrine
1 min
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
1 min
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
1 min
Alpha 2 Receptor
Characteristics
Gi subunit
Decrease Sympathetic Outflow
Decrease Insulin Release
Decrease Lipolysis
Increase Platelet Aggregation
Decrease Aqueous Humor Production
1 min
Epinephrine (Adrenaline)
Mechanism
Alpha and Beta Agonist
Indications
Anaphylaxis
Primary Open Angle Glaucoma (POAG)
Bleeding
Cardiac Arrest
Side Effects
Tachycardia
Hypertension
Tremors
Insomnia
Considerations
Multiple Strengths
1 min
Alpha 1 Receptor
Characteristics
Gq Subunit
Increase Vascular Smooth Muscle Contraction
Increase Pupillary Dilator Muscle Contraction
Increase Intestinal and Bladder Sphincter Muscle Contraction
1 min
Hypertension Assessment
Mechanism
Essential Hypertension
Secondary Hypertension
Assessment
Headache
Vision Changes
Nosebleed (Epistaxis)
Chest Pain
Syncope (Fainting)
Diagnosis
Average 2 Sets, 2 Minutes Apart
After 2 or More Visits
Nursing Considerations
Take BP Both Arms
Common in African Americans
1 min
Primary Hypertension Risk Factors
Excessive Alcohol Consumption
High Sodium Diet
Dyslipidemia
Obesity
African American
Advanced Age
Vitamin D Deficiency
Reduced Nephron number
Diabetes
Lack of Physical Activity
1 min
Blood Pressure Classification (JNC 7)
Classifications
Normal
Systolic (< 120)
Diastolic (< 80)
Prehypertension
Systolic +20 (120-139)
Diastolic +10 (80-89)
Stage 1 Hypertension
Systolic +20 (140-159)
Diastolic +10 (90-99)
Stage 2 Hypertension
Systolic + > 20 (160)
Diastolic + > 10 (100)
Hypertensive Crisis
Systolic > 180
Diastolic > 110
3 mins
Hypertension Intervention
Lifestyle Modifications
Weight Reduction and Exercise
Diet Changes
Relaxation Techniques
Smoking Cessation
Medications
Encourage Self Monitoring
1 min
Angiotensin-Converting Enzyme (ACE) Inhibitors
"-pril" Suffix
Mechanism of Action
Block Renin Angiotensin-Aldosterone System (RAAS)
Indications
Hypertension
Heart Failure
Side Effects
Dry Non-productive Cough
Hypotension
Dizziness
Possible Hyperkalemia
Angioedema
Nursing Considerations
Slowly Change Position
Do Not Stop Abruptly
1 min
Hypertension Medications
Diuretics
Beta Blockers
Angiotensin Receptor Blockers (ARBs)
Calcium Channel Blockers
ACE Inhibitors
1 min
Angiotensin II Receptor Blockers (ARBs)
Ends in "-sartan"
Mechanism of Action
Blocks Angiotensin II Receptor
Indications
Hypertension
Side Effects
Angioedema
Contraindications
Renal Artery Stenosis
Pregnancy
1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Essential Hypertension
Arrhythmias
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
1 min
Loop Diuretics
Mechanism of Action
Thick ascending limb of Loop of Henle
Inhibits Na+-K+-2Cl-
Sulfa drug
Drug Names
Furosemide
Lasix
Side Effects
Ototoxicity from Rapid Injection
Gout
Dehydration
Hypocalcemia
Hypokalemia
Orthostatic Hypotension
1 min
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
1 min
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
1 min
Hydrochlorothiazide HCTZ
Mechanism of Action
Inhibits Reabsorption NaCl and H2O
Indications
Edema
Mild to Moderate Hypertension
Side Effects
Hypokalemia
Hyponatremia
Dehydration
Hyperglycemia
Gout
Contraindications
Sulfa Allergy
Pregnancy and Breastfeeding
1 min
Prazosin (Minipress)
-osin suffix
Mechanisms
Selective Alpha-1 Receptor Blocker
Indications
Hypertension
Benign Prostatic Hyperplasia (BPH)
Nightmares
Side Effects
Orthostatic Hypotension
Tachycardia
Priapism / Inhibition of Ejaculation
Nasal Congestion
Considerations
First Dose Effect
Administer at Bedtime
2 mins
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
1 min
Loop Diuretic Education
Furosemide (Lasix)
Indications
Heart Failure
Pulmonary Edema
Acute Renal Failure (ARF)
Edema
Education
Notify the provider of weakness, dizziness, or muscle cramping
Increase Potassium Intake
Check BP Daily
Daily Weights and Monitor IandOs
1 min
Nitroglycerin
Mechanism of Action
Decreases Preload
Indications
Angina
Up to 3 doses q 5 mins
Side Effects
Headache
Hypotension
Contraindications
Viagra (Sildenafil)
Nursing Considerations
Assess Blood Pressure
Protect From Light
Use Glass Bottle and Special Tubing
Gloves for Applying Topically
1 min
Minoxidil (Loniten, Rogaine)
Mechanism
Vasodilates Arterioles
Indications
Severe Hypertension
Baldness
Side Effects
Reflex Tachycardia
Blood Volume Expansion
Hypertrichosis
Pericardial Effusion
Rash
Considerations
Give with Beta Blocker and Diuretic
2 mins
Hydralazine (Apresoline)
Indications
Severe Hypertension
CHF
Reduced Afterload
Pregnancy
Mechanism of Action
Vasodilates Arterioles
Side Effects
Drug-induced Lupus
Reflex Tachycardia
Hypotension
Considerations
Combined with Diuretic and Beta Blocker
1 min
Nitroprusside
Mechanism of Action
Direct Release of NO
Increase cGMP
Short Half-Life
Indications
Malignant Hypertension
Side Effect
Cyanide Toxicity
1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
1 min

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