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Blood Pressure

Hypertension

junio 5, 2018

[VidSitePro id=24 ]Hi guys welcome to empower and my name is caroline porter thomas thank you so much for watching my youtube channel and power in so in this video we’re going to go over the disease process hypertension we will discuss the medical treatment of patients with hypertension discuss lifestyle changes and medication therapy and diagnostic tests we will also discuss the importance of obtaining accurate blood pressure and we will also identify some of the complications that can arise from hypertension it is critical to be aware that your client is aware of the risk factors associated with hypertension in this video you will see why hypertension is known as the silent killer make sure you stay tuned to the channel and also sign up for email updates because after this video when we are done editing them we are going to post video questions with their rationales however if you do have an exam coming up feel free to look below in the description section or maybe I’ll put an annotation somewhere and you can actually go to my website where you can see a typed version of the questions so without any further ado let’s get started hypertension the pressure exerted by the blood on the walls of the arteries and other blood vessels is known as blood pressure it has two main components this systolic and the diastolic pressure this is solid pressure is the pressure with which the left ventricle of the heart pushes blood through the body while contracting and the diastolic pressure is the pressure exerted when the ventricle are filled with blood upon relaxation factors that can alter blood pressure our health and age of the person volume of blood in the body elasticity of the blood vessels and strength of the heartbeat for example if the arteries are narrow and the volume of blood pumped by the heart is high the person will experience a high blood pressure a high blood pressure can affect different organs of the body including the heart when blood pressure reaches approximately 140 over 90 millimeters of mercury or higher it is considered risky and this condition is known as hypertension or high blood pressure blood pressure measures all into five general categories which can be found on the American Heart Association’s website the five categories are normal pre hypertension high blood pressure Stage one high blood pressure stage 2 and finally hypertensive crisis where emergency care is needed the ranges for each are as following a normal blood pressure has a systolic blood pressure that is less than 120 millimeters and a diastolic which is less than 80 prehypertension with a systolic range from 120 to 139 or a diastolic range from 80 to 89 high blood pressure stage one with a systolic range from 140 to 159 or a diastolic range from 90 to 99 high blood pressure stage 2 with the systolic of 160 or higher or a diastolic of 100 or higher and finally hypertensive crisis with a systolic higher than 180 or a diastolic higher than 110 causes based on the cause there are two types of hypertension primary which is also known as essential hypertension and secondary hypertension primary hypertension is the most common type of hypertension it makes up for about 95% of hypertension cases and yet has no detectable causes as of now it is considered to be hereditary and it is also influenced by interaction with certain environmental factors secondary hypertension is a lot less common than essential hypertension forming 5% of all hypertensive cases but in this type of hypertension the blood pressure rises much higher than it does in the primary type of hypertension it is caused by underlying medical conditions and it is more likely to appear suddenly some of the medical conditions and medication that can cause secondary hypertension are alcohol abuse or chronic alcohol usage illegal drugs including and fed amines and cocaine thyroid problems adrenal gland problems various congenital defects of the blood vessels obstructive sleep apnea renal problems preeclampsia which is hypertension in pregnancy and certain medications including over-the-counter painkillers cold remedies control decongestants and other certain prescribed drugs signs and symptoms hypertension is known as the silent killer because generally hypertensive patients do not show any specific signs or symptoms even in a case of extremely high blood pressure certain hypertensive patients may feel vertigo lightheadedness dull headache fainting episodes tinnitus which is a hissing or buzzing sound in the ear and altered vision however the reason for these symptoms can be anxiety that comes with hypertension rather than the high blood pressure itself diagnostic tests hypertension is measured and detected with help of the spy Bowman monitors the diagnosis also involves a physical examination obtaining a good history and testing to identify the cause or also known as etiology and defines out if any organs are damaged the American Heart Association suggests that at least three measures on at least three separate healthcare visits are obtained it also suggests to read the patient’s blood pressure at different times of the day and after they have rested for more than five minutes in order to measure the blood pressure a blood pressure sleeve is attached to the patient’s upper arm patients may require sleeves of different sizes for instance if somebody is very thin they may need a small sleeve if somebody is obese they may need a larger sleeve the cups should cover two-thirds of the biceps and the bladder should be long enough to surround more than 80% of the arm and its width should be parallel approximately 40 percent or more of the arms parameter also for more accurate readings a mercury based big moment monitor are recommended as they are more precise than the automated ones the blood pressure is measured over inflating the sleeve over the expected systolic pressure next the air is really slowly while listening for pulsation of the brachial artery upon hearing the first pulse the reading is noted which represents the systolic pressure when the sound vanishes completely or a definite change is heard it is considered at this point to be the diastolic pressure blood pressure of the popliteal arteries at the thigh and the radial artery is at the forearm are both measured the same way systolic and diastolic pressures are both equally important however the systolic pressure becomes more important after the age of 60 it can get very high even when the diastolic pressure is normal for example a diastolic pressure may be less than 90 while a systolic pressure could be greater than 140 this is known as isolated systolic hypertension and is generally observed in older patients this is because there is loss of elasticity of the arteries and older people if the sphygmomanometer x’ readings and skate high blood pressure the doctor may perform a detailed physical examination and study the patient’s medical history in addition the provider may order other tests to detect any cardiovascular risk or damage to other target organs these tests may include blood tests to find out the levels of fasting plasma glucose sodium potassium creatinine thyroid stimulating hormone and lipid profile also an electrocardiogram may be used to measure the electrical activity of the heart they also may conduct a urinalysis the results of these tests may indicate the need for further testing and consultants for example the patient may need to consult a nephrologist you determine the severity of damage to the kidneys usually the younger the patient and the higher the blood pressure the more expensive the treatment plan prevention and management lifestyle changes are most often necessary bringing changes into one’s lifestyle plays an important part in preventing and even managing hypertension without medications some possible ways that one might be able to avoid medications for hypertension might include modifications to one’s diet plan including eating more fruits and vegetables and less sodium avoiding excessive alcohol quitting smoking exercising regularly maintaining a healthy weight and controlling stress medication therapy even with lifestyle modifications some hypertensive patients may need medications complying with a medication regimen as prescribed is often difficult for some patients because they may not feel different taking them this is why hypertension is known as the silent killer due to the fact that the patients are often asymptomatic it is very important that the nurse informs the patient the hypertension is the leading cause of heart attacks and strokes medications that are suggested for hypertension include the following ngo attention to receptor blockers which are also known as arms ARBs inhibit the reaction of a natural chemical that narrows down blood vessels this inhibition causes the blood vessels to relax angiotensin converting enzyme also known as ACE inhibitors are also used these medications inhibit the formation of may natural chemical that narrows down blood vessels as a result the blood vessels relax with a wider diameter for the blood to flow through it is most likely prescribed to patients with chronic kidney disease how seam channel blockers are also used this medication relaxes the muscles of the blood vessels some of them slow down the heart rate sometime this medication is also given with an ACE inhibitor in the case where ACE inhibitors may not effectively work on its own no grapefruit juice intensifies the effect of this medication which may put the patient at greater risk for side effects renin inhibitors are also used kidneys produce enzymes called renin which initiates a chain of reaction of chemicals that leads to high blood pressure renin inhibitors such as Alyce Caron or Ted Turner works by slowing down the formation of renin notes ARBs and ACE inhibitors should not be taken together with renin inhibitors because it can cause serious complications such as a stroke beta blockers are another effective medication by opening the blood vessels and reducing the workload of the heart these medications make the heart beat slower with less force by itself or with other antihypertensive drugs it can produce better results by xiah diuretics also known as water pills they work by acting on the kidneys to remove excess sodium and water from the body this decreases the blood volume in the body it is one of the most recommended medications and managing hypertension resistant hypertension when blood pressure stays high even with three antihypertensive age of different drug classes used together it is known as resistant hypertension it is usually caused by low adherence to treatment hypertensive crisis accelerated hypertension which is also known as hypertensive crisis or emergency is when the blood pressure is extremely high such as 200 over 130 along with end organ damage for instance eclampsia dissection encephalopathy pulmonary edema papilledema angio Pathak hemolytic anemia and/or nephropathy patients with these syndromes may need same-day evaluation and immediate management to reduce the high blood pressure within hours to minutes hypertensive urgency is when the blood pressure reaches high numbers such as 180 over 120 but there is no expected risk of end organ damage this condition needs to be managed by safely lowering blood pressure over a few days in summary the assessment of hypertension is extensive and time consuming you should now be aware of the importance of accurate diagnosis and impressing your clients to follow good treatment to hopefully prevent complications such as CHF stroke vision problems peripheral artery disease and renal disease your goal as the clients nurse is very important in helping them understand that hypertension is a silent killer alright guys we really hope that you enjoyed that video going over hypertension I know that this is a disease process that you will see a lot – no matter where you work and of course you will see it in nursing school so like I mentioned before make sure you stay tuned to this channel and sign up for email updates because we are going to be posting full videos with the rationales so that we have time to properly discuss the questions as soon as we are done I didn’t know we will post them all right I love you guys so much I’ll see you next time love you bye

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