This document provides information on hypertension including: 1) The definition of hypertension as blood pressure higher than 140/90 mm Hg on three readings weeks apart. 2) Hypertension can cause damage to organs like the heart, brain, kidneys, and eyes if left untreated. 3) Lifestyle modifications like weight loss, diet, exercise, limiting alcohol and smoking can help control blood pressure. Medications including diuretics, beta-blockers, ACE inhibitors, and others may also be used.

1. Nursing 210
Advanced
Cardiac
UNIT 2
Laurie Brown RN, MSN, MPA-HA, CCRN

2. Hypertension
 “In adults, a condition in which the blood
pressure (BP) is higher than 140 mm Hg
systolic of 90 mm Hg diastolic on three
(two) separate readings… recorded
several weeks apart”.
Blood Pressure = Cardiac Output x Systemic Vascular Resistance

4. Relevance
 Why is
hypertension
clinically
significant?

5. Procedure
Take the Pulse obliteration pressure
OR
Known Blood Pressure
 Add 20-30 mm Hg
 Inflate Bp cuff to this number
 Use the BELL of stethoscope take the
Blood Pressure

6. Types of Hypertension
 “White Coat” Hypertension
 Malignant Hypertension
 Hypertensive Urgency
 Pregnancy Induced
Hypertension

7. Symptoms
 Often, there are no symptoms
until damage has been done…

8. Complications
 Heart
 Brain
 Kidneys
 Aorta
 Arterial vessels
 Eyes

9. Lifestyle modifications
weight loss, diet, exercise, stop smoking, limit alcohol
Medication
Diuretics or Beta-Blocker
Add second drug or substitute
another drug
Add third drug and/or substitute
second drug
Continue adding agents from
other classes Referral to
hypertensive specialist
Step 1
Step 2
Step 3
Step 4
Step 5
Medication Management

10. Causes of Resistant Hypertension
 Improper BP measurement
 Excessive sodium intake
 Inadequate diuretic therapy
 Medication
 Inadequate dose
 Drug actions and interactions
 Smoking

11. Lifestyle modifications
 Weight reduction
 DASH eating plan
 Dietary sodium restriction
 Aerobic physical activity
 Moderation of alcohol consumption
 Cessation of smoking

12. Medications
Classifications and Action
 Diuretics
 Alpha Adrenergic Blockers
 Beta Adrenergic Blockers (olol)
 Calcium Antagonist (ipine)
 ACE Inhibitor (pril)
 Angiotensin II Antagonist (Receptor
blockers or ARB’s) (sartan)
 Vasodilator

13. BP = CO x SVR

14. Treatment Program
Individualized
Step-Care
Therapy for
Hypertension

15. Review
 Analyze this EKG
 What medical orders do you
anticipate?
EKG