Hypertension (High Blood Pressure) The consistent elevation of systemic arterial blood pressure.

Drugs Ace Inhibitors Calcium Channel Blockers Adrenergic Antagonists Enalapril (Vasotec) Calcium Channel Blockers Nifedipine (Procardia) Adrenergic Antagonists Doxazosin (Cardura) Direct Vasodilators Hydralazine (Apresoline)

http://www.youtube.com/watch?feature=player_detailpage&v=tBQa8IBzP6I

Classification Etiology: (Genetic & Environmental) Normal 119/79 or less Prehypertension 120-39/80-89 Stage I Hypertension 140-159/90-99 Stage II Hypertension 160 of higher/100 or higher Etiology: (Genetic & Environmental) Disease Drugs Diet Alcohol & Smoking

Factors Responsible for BP Cardiac Output –volume of blood pumped per minute Stroke Volume –amount of blood pumped by a ventricle in one contraction Peripheral Resistance –friction in the arteries (diameter) Blood Volume –amount of blood in vascular system

Consequences Heart, Brain, Kidneys, and Retina Heart works harder to pump blood to organs and tissues = HF Vascular System –damage blood vessels that supply blood & O2 to brain = CVA (stroke) Kidney Retina

Nurse’s Role Vital Signs Dizziness/ Lightheaded Labs (electrolytes –potassium) Daily weights Urinary output Lifestyle changes (diet & exercise) Safety Education

Prototype Drugs Ace Inhibitors Calcium Channel Blockers Enalapril (Vasotec) Calcium Channel Blockers Nifedipine (Procardia) Adrenergic Antagonists Doxazosin (Cardura) Direct Vasodilators Hydralazine (Apresoline)

Heart Failure Inability of the ventricles to pump enough blood to meet the body’s metabolic demands

Drugs ACE Inhibitor & Angiotensin receptor blocker Diuretics Lisinopril (Prinivil) Diuretics Cardiac Glycosides Digoxin Beta-adrenergic blockers metoprolol

Blood Circulation

Heart Failure Contractility –strength of contraction of heart Inotropic effect –change in contractility of heart Positive inotropic Negative inotropic

Heart Failure Cardiac output –amt of blood pumped by each ventricle per minute Preload –degree of which myocardial fibers stretched prior to contraction Afterload –degree of pressure in aorta that must be overcome for blood to be ejected from left ventricle

Symptoms Associated with HF

Nurse’s Role Vital Signs Dizziness/ Lightheaded Apical Pulse Dizziness/ Lightheaded Labs (electrolytes –potassium) Daily weights Urinary output Lifestyle changes (diet & exercise) Safety Education Documentation

HEART FAILURE Drugs ACE Inhibitor & Angiotensin receptor blocker Lisinopril (Prinivil) Diuretics Cardiac Glycosides Digoxin Beta-adrenergic blockers metoprolol

Angina Pectoris & Myocardial Infarction (MI)

Drugs Nitrates Beta Blockers Calcium Channel Blockers Thrombolytics Nitroglycerin Beta Blockers Atenolol (Tenormin) Calcium Channel Blockers Diltiazem (Cardizem) Thrombolytics reteplase

Pathophysiology of MI Plaque build up narrow branches of coronary arteries pieces of unstable plaque break off & lodge in small vessels of heart plaque activates coagulation cascade causing clot obstruction of vessel inability for blood flow deprived O2 to heart ischemia death of muscle cells

Factors Affecting Myocardial Oxygen Supply & Demand Physical exertion Emotional excitement Narrowed coronary arteries

Nurse’s Role Vital Signs –Cardiac monitoring Frequent physical assessment (neuro/cardiac/respiratory) Dizziness/ Lightheaded Labs (electrolytes –potassium) Daily weights Urinary output Lifestyle changes (diet & exercise) Safety Education

Angina and Myocardial Infarct Drugs Nitrates Nitroglycerin Beta Blockers Atenolol (Tenormin) Calcium Channel Blockers Diltiazem (Cardizem) Thrombolytics reteplase