Hypertension Definition and Classification

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Questions and Answers

Which of the following is a recognized cause of hypertension?

Hyperaldosteronism (correct)

Appendicitis

Sepsis

Anemia

What is one of the primary goals of hypertension treatment?

To achieve and maintain blood pressure lower than 140/90 mm Hg (correct)

To increase sodium intake

To eliminate all medications

To decrease potassium reabsorption

Which lifestyle modification is suggested to help manage hypertension?

Regular physical activity (correct)

Delay sleep schedules

Increase salt intake

Practice sedentary behavior

Which of the following medications is classified as a diuretic?

Loop diuretics Signup and view all the answers

In severe hypertension, which of the following can be a clinical manifestation?

Retinal diseases Signup and view all the answers

What is the definition of a hypertensive emergency?

Blood pressure above 180 mm Hg systolic with target organ damage Signup and view all the answers

Resistance to insulin action is considered a common factor linked to which of the following conditions?

Type 2 diabetes and hypertension Signup and view all the answers

What type of diagnostic test is used to assess left ventricular hypertrophy in hypertension patients?

12-lead electrocardiogram (ECG) Signup and view all the answers

What is the recommended approach for home management in patients with hypertension?

Monitoring blood pressure regularly Signup and view all the answers

Which of the following is a common assessment tool for diagnosing hypertension?

Blood chemistry analysis Signup and view all the answers

What characterizes systolic blood pressure (SBP) hypertension?

SBP of 140 mm Hg or higher Signup and view all the answers

What is the primary characteristic of primary hypertension?

It accounts for the majority of hypertension cases. Signup and view all the answers

What is the major risk factor associated with hypertension?

Age and family history Signup and view all the answers

What is often referred to as the 'silent killer'?

Hypertension Signup and view all the answers

What defines secondary hypertension?

High blood pressure due to a specific identifiable cause Signup and view all the answers

Which of the following is a recommended treatment approach for hypertension?

Lifestyle changes and medication therapy Signup and view all the answers

What is the minimum number of blood pressure measurements needed to diagnose hypertension?

Two or more accurate measurements over time Signup and view all the answers

What does a diastolic blood pressure (DBP) of 90 mm Hg indicate?

Hypertension Signup and view all the answers

Which of the following statements is NOT true about hypertension?

It is always caused by lifestyle factors. Signup and view all the answers

In managing a patient with hypertension, which framework should be used for care?

The nursing process Signup and view all the answers

Study Notes

Hypertension Definition and Classification

Hypertension is defined as a systolic blood pressure (SBP) of 140 mm Hg or higher, or a diastolic blood pressure (DBP) of 90 mm Hg or higher, averaged over two or more accurate measurements taken 1-4 weeks apart by a healthcare provider.
It's sometimes called the "silent killer" because it often has no noticeable symptoms until significant damage occurs.
Hypertension can be primary (unidentified cause, majority of cases) or secondary (related to identifiable causes like kidney disease, renal artery stenosis, hyperaldosteronism, certain medications, or pregnancy).

Hypertension Risk Factors

Risk factors are detailed in Chart 31-1 on pages 2405-2406 of the text.

Hypertension Pathophysiology

Several factors contribute to hypertension, including:
- Increased sympathetic nervous system activity.
- Increased renal reabsorption of sodium, chloride, and water.
- Increased renin-angiotensin-aldosterone system activity, leading to expanded extracellular fluid and increased systemic vascular resistance.
- Decreased vasodilation of arterioles.
- Resistance to insulin action (linked to type 2 diabetes, hypertriglyceridemia, obesity, and glucose intolerance).
- Activation of innate and adaptive immune responses contributing to renal inflammation and dysfunction.

Hypertension Clinical Manifestations

Often, there are no noticeable symptoms other than elevated blood pressure readings.
Severe hypertension (with target organ damage) can present with:
- Retinal and eye diseases
- Kidney damage
- Heart disease
- Stroke
- Peripheral arterial disease

Hypertension Assessment and Diagnostics

A thorough history and physical examination are crucial, including looking for target organ damage.
Laboratory tests might include:
- Urinalysis
- Blood tests (sodium, potassium, creatinine, fasting glucose, total and HDL cholesterol levels)
- 12-lead ECG
- Echocardiography to assess left ventricular hypertrophy

Hypertension Medical Management

Treatment aims to prevent complications and death by maintaining blood pressure below 140/90 mm Hg (or below 150/90 mm Hg in patients over 60 or 80).
Lifestyle modifications (detailed in Table 31-2) and medication therapy are used (as detailed in Figure 31-2 on page 2407). Specific medications include diuretics, beta-blockers, ACE inhibitors, and others.

Hypertension Nursing Process

Nursing Diagnoses: Common diagnoses include knowledge deficit regarding treatment and disease management, and noncompliance related to medication side effects.
Nursing Interventions: Strategies focus on:
- Increasing patient knowledge.
- Promoting adherence to the therapeutic regimen.
- Supporting home, community-based, and transitional care.
- Monitoring and managing potential complications.

Hypertensive Crises

Hypertensive emergencies involve acutely high blood pressure causing life-threatening target organ damage. Rapid reduction in blood pressure is needed (aiming for a decrease of 20-25% in the first hour).
Hypertensive urgencies involve elevated blood pressure without immediate target organ damage, requiring normalization within 24-48 hours, using slower reduction strategies.

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Description

This quiz covers the definition, classification, and risk factors of hypertension. Understand the difference between primary and secondary hypertension, as well as the various factors contributing to this condition. It's essential for anyone studying health or medicine to grasp these fundamental concepts.