Chapter 34_ Hypertension课件.ppt

Emergency Treatment of Malignant In true emergency goal is to lower BP within 1 to 2 hours Nitropress, nitroglycerine, Normodyne IV given if critical If not critical, Procardia, verapamil, captopril, minipress given orally. Oxygen given to reduce hypoxia-induced tachycardia Nursing care Pg. 514 Give meds using pump, check rate hourly Automatic BP cuff if arterial line not used Restrict activity/ bedrest Report 160/115 stat Monitor for neurologic, cardiac and renal complications Crash cart in room FYI Accelerated hypertension is characterized by markedly elevated BP Malignant hypertension is a dangerously elevated BP Both have changes in the eye. Ophthamologic changes indicate extremely high intravascular and rising intracranial pressures HTN: Complications—4Cs CHF (congestive heart failure) CVA (cerebrovascular accident) CAD (coronary artery disease) CRF (chronic renal failure) Interactive Crash Cart Tutorial (FYI) scroll down link to view /Home%20Page/Providers%20Page/the_learing_center.htm Chapter 33: Hypertension Overview of BP Pg. 507 Force produced by the volume of blood within the walls of arteries. Measured pressure reflects the ability of arteries to stretch and fill with blood, efficiency of heart as a pump and the volume of circulating blood Overview of BP Affected by age, body size, diet, activity, emotions, pain, position, gender, time of day and disease states ***Use of Birth Control Pills**** Overview of BP Studies of healthy persons show that blood pressure can fluctuate within a wide range and still be normal. It is important to obtain several measurements for comparison. ****A diastolic elevation is more serious, reflecting pressure on arterial wall during the resting phase of the cardiac cycle**** Arterial Blood Pressure Regulated by autonomic nervous system, kidneys and endocrine glands Normal ranges from 100/60 to 139/89 Tends to increase age, most likely from arteriosclerotic and atherosclerotic changes in blood vessels or other effec