Cardiovascular

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created 7 years ago by lilmisskoko
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Medical-Surgical Nursing - E-Book
Chapters 32-35, 37, 38
Med Surge 1
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1

Nursing management of hypertension

BP baseline: if abnormal ck manually

teach pt how to take BP and keep diary

If they have HA or cold and are tx with OTC= ^ BP (Sudafed)

Teach how to mng stress

2

Hypertensive Urgency

develops over days or weeks

no target organ damage

managed with oral meds

3

Hypertensive Emergency

develops over hrs or days

target organ damage

4

Management of hypertensive emergency

administer IV meds (vasodilators, beta- blockers, ace inhibitor)

monitor BP q 2-3 min (artereial line)

monitor EKG

hourly urine output

5

Antihypertensive Teaching (PRESSURE)

Pressure (blood) monitor

Rise slowly to reduce orthostatic hypotension

Eating must be considered (diet)

Stay on Meds

Skipping or stopping is a no-no

Undesirable responses

Remind to exercise and dec alcohol

Eliminate smoking; educate

6

Preload

volume of blood in ventricles at the end of diastole

7

Afterload

Mean Arterial Pressure: MAP= (SBP + 2DBP)/3

8

ARBS

Administer meds without regard to food

Renal function tests

Blocks vasoconstriction effect of Renin-angiotensin system

Salt substitution or K sup- do not use

9

Troponin I

Myocardial Injury

elevated levels + MI

10

Troponin T

elevated for up to 14 days

11

CRP

indicator for risk of developing MI (c-reactive protein)

<1= low risk

1-3= moderate

>3= high risk

12

Serum lipids

total cholesterol, LDL, HDL, trigycerides

13

BNP

used for categorizing HF (b- type natriuretic peptide)

<100= good

100-500= moderate HF

>500= out of control

14

Gerontological considerations for hypertension

atherosclerosis- hypertension-CAD-HF

valvular insufficiency, a-fib, slow compensatory mechanism- orthostatic hypotension- risk for falls