Hypertension Diagnosis and Management
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Questions and Answers

A patient's blood pressure consistently reads 132/86 mmHg. According to the established hypertension stages, how should this patient's blood pressure be classified?

  • Elevated
  • Normal
  • Stage 2 Hypertension
  • Stage 1 Hypertension (correct)

Which of the following complications is most directly associated with long-standing, uncontrolled hypertension?

  • Osteoporosis
  • Gastroesophageal Reflux Disease (GERD)
  • Peripheral Vascular Disease (PVD) (correct)
  • Hyperthyroidism

Which of the following diagnostic findings would be most indicative of target organ damage in a patient with chronic hypertension?

  • Increased serum potassium
  • Microalbuminuria (correct)
  • Decreased blood glucose
  • Elevated white blood cell count

A patient with hypertension is prescribed an ACE inhibitor. What is the primary mechanism by which this medication helps to lower blood pressure?

<p>By blocking the conversion of angiotensin I to angiotensin II (C)</p> Signup and view all the answers

Which lifestyle modification would be most beneficial for a patient newly diagnosed with elevated blood pressure?

<p>Reducing saturated fat intake and adopting the DASH diet (C)</p> Signup and view all the answers

A patient with a decreased cardiac output (CO) is likely to exhibit which combination of the following signs and symptoms?

<p>Hypotension, decreased peripheral perfusion, shortness of breath, and confusion. (A)</p> Signup and view all the answers

Which scenario would result in an increased afterload on the heart?

<p>Vasoconstriction due to the release of endothelin. (D)</p> Signup and view all the answers

A patient's blood pressure is consistently elevated at 140/90 mmHg during three separate clinic visits. According to the information, which of the following is the most appropriate initial action?

<p>Recommend lifestyle modifications and schedule a follow-up appointment. (D)</p> Signup and view all the answers

A patient's ECG shows a heart rate of 120 bpm originating from the sinoatrial (SA) node. Which of the following best describes this rhythm?

<p>Sinus tachycardia. (B)</p> Signup and view all the answers

The renin-angiotensin-aldosterone system (RAAS) is activated in response to decreased blood pressure. How does aldosterone contribute to restoring blood pressure?

<p>Increases sodium and water reabsorption in the kidneys. (D)</p> Signup and view all the answers

A patient presents with shortness of breath, dyspnea, and edema. Physical examination reveals jugular vein distension and hepatomegaly. Which cardiac condition is most likely associated with these findings?

<p>Congestive Heart Failure (A)</p> Signup and view all the answers

A patient is diagnosed with restrictive cardiomyopathy. Which of the following treatment strategies would be most appropriate, based on the information provided?

<p>Treatment similar to heart failure management (B)</p> Signup and view all the answers

A patient experiencing chest pain, syncope, and palpitations is diagnosed with an arrhythmia. Which physical characteristic is most associated with an arrhythmia?

<p>Stiff heart (D)</p> Signup and view all the answers

A patient is diagnosed with mitral regurgitation. Which of the following findings would you expect to see in this patient?

<p>Holosystolic murmur (B)</p> Signup and view all the answers

A patient presents with a history of rheumatic fever and is now experiencing progressive shortness of breath. An echocardiogram reveals narrowing of the mitral valve. Which of the following conditions is the most likely diagnosis?

<p>Mitral stenosis (B)</p> Signup and view all the answers

Which pathological process is the initial event in the development of atherosclerosis, potentially leading to coronary artery disease?

<p>Damage to the endothelial lining of the arteries. (D)</p> Signup and view all the answers

A patient with chronic stable angina is prescribed a beta-blocker. How does this medication primarily reduce chest pain?

<p>By decreasing heart rate and contractility, thus reducing myocardial oxygen demand. (A)</p> Signup and view all the answers

A patient with left-sided heart failure reports sudden shortness of breath while lying down at night. Which term best describes this symptom?

<p>Paroxysmal nocturnal dyspnea (A)</p> Signup and view all the answers

In the management of a patient with heart failure, what is the primary rationale for administering ACE inhibitors?

<p>To reduce preload and afterload, decreasing the heart's workload. (C)</p> Signup and view all the answers

A patient diagnosed with right-sided heart failure is most likely to exhibit which of the following signs and symptoms?

<p>Dependent edema and jugular vein distension. (B)</p> Signup and view all the answers

Which of the following diagnostic findings would most strongly suggest a diagnosis of systolic heart failure (HFrEF)?

<p>An ejection fraction (EF) of 40%. (B)</p> Signup and view all the answers

What is the primary mechanism by which statin medications help to prevent complications of coronary artery disease?

<p>By reducing levels of low-density lipoprotein (LDL). (D)</p> Signup and view all the answers

A patient reports chest pain that occurs predictably with exertion and is relieved by rest or nitroglycerin. This pattern is most consistent with which type of angina?

<p>Chronic stable angina (C)</p> Signup and view all the answers

A patient with a history of chronic obstructive pulmonary disease (COPD) is experiencing dyspnea. Which oxygen delivery method would be most appropriate to administer a precise and consistent oxygen concentration?

<p>Venturi mask (A)</p> Signup and view all the answers

During an episode of epistaxis, initial first aid interventions should include which action?

<p>Leaning forward and applying pressure to the soft part of the nose. (A)</p> Signup and view all the answers

A patient with allergic rhinitis presents with persistent nasal congestion, clear nasal drainage, and frequent sneezing. Which combination of medications would be most appropriate for managing these symptoms?

<p>Antihistamines, decongestants, and corticosteroid nasal spray (A)</p> Signup and view all the answers

A patient using pursed-lip breathing (PLB) asks about its purpose. What is the most appropriate explanation of the primary benefit of PLB?

<p>To prevent bronchial collapse and prolong exhalation. (B)</p> Signup and view all the answers

A patient reports symptoms of acute sinusitis following a cold. How long do the symptoms typically need to persist to be classified as acute sinusitis?

<p>1-4 weeks (B)</p> Signup and view all the answers

A patient presents with a persistent cough, fever, and shortness of breath. Auscultation reveals bronchial breath sounds and diminished lung sounds in the lower lobes. Which of the following is the MOST likely underlying pathological process?

<p>Inflammation and consolidation of lung tissue with fluid and debris. (D)</p> Signup and view all the answers

A patient diagnosed with community-acquired pneumonia (CAP) develops a sudden onset of severe hypoxemia despite supplemental oxygen. Which of the following complications should be suspected?

<p>Progression to acute respiratory distress syndrome (ARDS). (A)</p> Signup and view all the answers

During an influenza outbreak, a public health campaign emphasizes preventative measures. Which intervention would MOST effectively reduce the spread of the influenza virus?

<p>Promoting annual influenza vaccination and frequent handwashing. (D)</p> Signup and view all the answers

A patient with suspected pneumonia undergoes a bronchoscopy. What is the MOST likely rationale for performing this diagnostic procedure?

<p>To directly visualize the airways and obtain samples for culture and analysis. (D)</p> Signup and view all the answers

A patient is diagnosed with influenza A and reports symptom onset 48 hours ago. Which of the following interventions would be MOST appropriate?

<p>Initiate antiviral therapy with an agent like oseltamivir. (C)</p> Signup and view all the answers

A patient diagnosed with peripheral artery disease (PAD) reports experiencing intermittent claudication. What physiological process primarily contributes to this symptom?

<p>Reduced arterial blood flow to the muscles, causing ischemia and pain during activity. (C)</p> Signup and view all the answers

A patient with acute arterial ischemia in the left leg suddenly reports numbness and inability to move the foot. Which action should the nurse prioritize?

<p>Preparing the patient for immediate intervention to restore arterial blood flow. (C)</p> Signup and view all the answers

A patient is being assessed for deep vein thrombosis (DVT). Which finding is most indicative of a DVT in the lower extremity?

<p>Unilateral leg pain, edema, and dilated superficial veins. (A)</p> Signup and view all the answers

A patient with a history of varicose veins asks about preventing complications. Which of the following would you recommend?

<p>Avoid prolonged standing or sitting and use compression stockings. (A)</p> Signup and view all the answers

A patient with chronic venous insufficiency has developed a venous stasis ulcer on their lower leg. What is the priority nursing intervention for this patient?

<p>Implementing compression therapy to improve venous return. (A)</p> Signup and view all the answers

A patient is post-operative following a femoral-popliteal bypass graft for PAD. Which assessment finding requires immediate notification of the health care provider?

<p>Increased pain in the operative leg unrelieved by analgesics. (B)</p> Signup and view all the answers

A patient on bed rest following surgery is prescribed prophylactic heparin. What is the primary rationale for this medication?

<p>To prevent platelet aggregation and reduce the risk of thrombus formation. (C)</p> Signup and view all the answers

Which component of Virchow's triad is most directly addressed through the use of compression stockings in a patient at risk for venous thromboembolism (VTE)?

<p>Venous stasis. (C)</p> Signup and view all the answers

Flashcards

Normal Blood Pressure

Systolic BP ≤ 120 mmHg and diastolic BP ≤ 80 mmHg.

Elevated Blood Pressure

Systolic BP 120-129 mmHg and diastolic BP < 80 mmHg.

Hypertension's Etilogical Damage

Vessel damage, blurred vision, hemorrhage, and visual disturbances.

HTN Complications

Heart failure, stroke, kidney damage, peripheral vascular disease, and coronary artery disease.

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Lifestyle Modifications for BP

Weight management, DASH diet, exercise, and reduced fat intake.

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Cardiac Conduction Pathway

Sequence of heart's electrical activity: SA node → AV node → Bundle of His → Purkinje fibers (ventricular depolarization).

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Cardiac Output (CO)

The amount of blood pumped by the heart per minute. Calculated by Stroke Volume x Heart Rate.

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Preload

The volume of blood in the ventricles at the end of diastole (filling). Increased by fluid volume.

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Afterload

The resistance the left ventricle must overcome to circulate blood. Increased by vasoconstriction.

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Blood Pressure (BP)

The product of Cardiac Output (CO) and Systemic Vascular Resistance (SVR). Normal BP is around 120/80 mmHg.

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Aortic Stenosis

Obstruction of blood flow from the aorta. Can be valvular or caused by dilation.

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Mitral Stenosis

Narrowing of the mitral valve. Often caused by rheumatic fever or congenital defects.

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Mitral Regurgitation

Backflow of blood from the left ventricle into the left atrium during systole, causing pulmonary edema.

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Aortic Regurgitation

Backflow of blood from the aorta into the left ventricle, leading to ventricular dilation and hypertrophy.

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Congestive Heart Failure (CHF)

Heart's inability to pump enough blood to meet the body's needs, leading to fluid build-up and symptoms like shortness of breath and edema.

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PLB Purpose

Prolongs exhalation to prevent bronchial collapse.

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Nasal Cannula

1-6 lpm; delivers a variable FiO2 (approx. 24-44% O2).

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Causes of Epistaxis

Trauma, medications, or underlying conditions.

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Epistaxis First Aid

Lean forward, pinch the nose for 5-15 minutes.

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Allergic Rhinitis

Inflammation of the nasal passages due to allergens.

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Atherosclerosis

Buildup of fats, cholesterol, and other substances in artery walls.

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Chronic Stable Angina

Chest pain due to reduced blood flow to the heart, usually triggered by exertion.

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Nitrates

Medications that widen blood vessels, increasing blood flow and decreasing blood pressure.

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Beta Blockers (BB)

Medications that slow heart rate and lower blood pressure.

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CABG

Procedure to create new blood vessels around blocked arteries in the heart.

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Heart Failure

Heart's inability to pump enough blood to meet the body's needs.

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Right-Sided Heart Failure Symptoms

Fluid buildup, enlargement of organs (liver), edema, and neck vein distention.

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Left-Sided Heart Failure (Systolic)

Inability of the left ventricle to pump blood effectively, leading to reduced ejection fraction.

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Peripheral Artery Disease (PAD)

Thickening of arterial walls causing narrowing. Risk factors include smoking, diabetes, hypertension, hyperlipidemia, and atherosclerosis.

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Acute Arterial Ischemia

Sudden blood flow interruption. Manifests as the 6 Ps: Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia.

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Venous Thrombosis (DVT/VTE)

Blood clot in a vein, can lead to pulmonary embolism (PE). Risk increased by smoking, birth control, and prolonged bed rest.

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Virchow's Triad

Endothelial damage, hypercoagulability, and stasis of blood flow, increasing venous thrombosis risk.

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Varicose Veins

Retrograde blood flow in veins due to valve incompetence. Symptoms include aching pain, heaviness, and swelling.

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Chronic Venous Insufficiency

Blood flow stagnation in the veins, leading to symptoms like leathery skin, ulcers, and edema.

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PAD Manifestations

Weak or absent pulse, intermittent claudication, pallor on elevation, dependent rubor.

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VTE Prevention

Early mobilization, heparin, anticoagulants, compression stockings to prevent venous thromboembolism (VTE).

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Influenza (Flu)

Viral infection causing global outbreaks. Transmitted via droplets, incubation is short.

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RIDT (Rapid Flu Test)

Rapid diagnostic test for influenza, using nasal samples, results within 48 hours.

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Pneumonia

Infection of the lungs, can be acquired in the community or hospital.

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Pneumonia Pathophysiology

Inflammation and fluid/debris buildup in the lungs, hindering gas exchange.

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Atelectasis

Collapsed alveoli, leading to reduced gas exchange. Can be caused by obstruction.

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