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103 terms

BLOOD PRESSURE

STUDY
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BLOOD PRESSURE
THE AMOUNT OF FORCE EXERTED AGAINST THE ARTERY WALLS AS BLOOD FLOWS THROUGH THE VESSEL IS KNOW AS BLOOD PRESSURE
SYSTOLIC
PRESSURE THAT IS EXERTED ON THE ARTERY AS BLOOD MOVES THROUGH AT PEAK CONTRACTION OF THE HEART (CONTRACTING)
DIASTOLIC
REPRESENTS THE PRESSURE IN THE ARTERY WHEN THE HEART IS RESTING BETWEEN BEATS (RELAXING)
PRIMARY OR ESSENTIAL
HYPERTENSION
CAUSE OF HIGH BLOOD PRESSURE IS UNKNOWN
THERE IS NO KNOWN CURE FOR HIGH BLOOD PRESSURE
LIFESTYLE MODIFICATIONS HAVE A ROLE IN PREVENTION OF HIGH BLOOD PRESSURE
SECONDARY
HYPERTENSION
THERE IS AN IDENTIFIABLE CAUSE
*KIDNEY DISORDER, TUMOR, * OTHER MEDICATIONS
CONSEQUENCES OF
UNCONTROLLED HBP
CHF, STROKE (BRAIN ATTACK),
RENAL FAILURE,
MYOCARDIAL INFARCTION (HEART ATTACK)
BLURRED VISION AND OR BLINDNESS
(OPTIC NERVE DAMAGE)
FRAMINGHAM STUDY
A LARGE SCALE, 30 YEAR PROSPECTIVE STUDY REVEALED A STRONG ASSOCIATION BETWEEN HIGH BLOOD PRESSURE AND THE DEVELOPEMENT OF CARDIOVASCULAR AND RENAL DISEASES
VETERANS ADMINISTRATION
COOPERATIVE STUDY (VA)
DRUG THERAPY IN THE SEVERE HYPERTENSIVE GROUP
(AVERAGE 115/120 MM HG) AND MODERATE HYPERTENSIVE GROUP (AVERAGE 105/114 MM HG) REVEALED A SIGNIFICANT REDUCTION IN MORTALITY WHEN HIGH BLOOD PRESSURE WAS TREATED AND CONTROLLED WITH DRUG THERAPY
HYPERTENSION DETECTION AND
FOLLOW-UP PROGRAM (HDFP)
CONTROLLING BLOOD PRESSURE IN PERSONS WITH CONFIRMED BASELINE DIASTOLIC BLOOD PRESSURE OF 90 MM TO 104 MM HG RESULTED IN A SIGNIFICANT REDUCTION IN 5 YEAR MORTALITY FROM ALL CAUSES (STROKE, HEART FAILURE, AND RENAL FAILURE)
SYSTOLIC HYPERTENSION IN THE
ELDERLY PROGRAM (SHEP)
THE EFFICIENCY OF TREATING THE ELDERLY POPULATION (60 + YEARS) WITH ISOLATED SYSTOLIC HYPERTENSION (ISH) SIGNIFICANTLY REDUCED THE INCIDENCE OF STROKE
NON-MODIFIABLE
NON-CHANGEABLE
GENDER-MALES MORE LIKELY TO BEAT RISK THAN WOMEN
RACE-MORE COMMON IN BLACK PEOPLE FEMALES
AGE-NOT AS YOUNG, LESS EXCERSIZE
FAMILY HISTORY--MORE LIKELY TO DEVELOPE
MAY BE MODIFIABLE
(POSSIBLE TO CHANGE)
LIABILITY OF BLOOD PRESSURE
HIGH RESTING PULSE RATE
MODIFIABLE
(CAN BE CHANGED)
OBESITY
SODIUM INTAKE
ALCOHOL(24 OZ BEER FOR MEN 1/2 FOR WOMEN)
(8 OZ WINE FOR MEN 1/2 FOR WOMEN)
SEDENTARY LIFESTYLE(LAZY)
PHYSICAL INACTIVITY
CARDIOVASCULAR
RISK FACTORS
HIGH CHOLESTEROL
SMOKING
HIGH BLOOD PRESSURE
SEDENTARY LIFESTYLE/
PHYSICALLY INACTIVE
OBESITY
DIABETES
STAGES IN BLOOD PRESSURE
CONTROL PROCESS
MEASUREMENT, AWARENESS,
TREATMENT, CONTROL
MEASUREMENT
AN INDIVIDUAL NEEDS AN ACCURATE BLOOD PRESSURE MEASUREMENT BEFORE HE/SHE CAN BE MADE AWARE THE BLOOD PRESSURE READING IS ELEVATED
AWARENESS
AN INDIVIDUAL NEEDS TO KNOW WHAT HIS/HER BLOOD PRESSURE READING IS, WHAT IT MEANS, AND THE COMMON MISCONCEPTIONS OF HIGH BLOOD PRESSURE
TREATMENT
DIAGNOSIS NEEDS TO BE MADE BY THE PHYSICIAN, THEN AN INDIVIDUALIZED TREATMENT PLAN SHOULD BE DEVELOPED
CONTROL
AN EFFECTIVE TREATMENT PLAN WILL ACHIEVE BLOOD PRESSURE CONTROL AND MAINTAIN THIS CONTROL OVER THE INDIVIDUAL'S LIFETIME
TWO WEAK LINKS IN CONTROLLING
HIGH BLOOD PRESSURE
FAILURE TO BE DIAGNOSED
FAILURE TO ACHIEVE AND MAINTAIN CONTROL
(PRIMARY CONCERN)
FAILURE TO BE DIAGNOSED
STRENGTHEN WEAK LINK BY STANDARD REFERRAL LEVELS, FOLLOW-UP APPOINTMENTS, PATIENT EDUCATION, GIVE CLEAR MESSAGES
FAILURE TO ACHIEVE AND MAINTAIN CONTROL
(PRIMARY CONCERN)
STRENGTHEN WEAK LINK BY
GOOD PATIENT/PROVIDER COMMUNICATION
INDIVIDUALIZED TREATMENT REGIMEN
CORRECT COMMON MISCONCEPTIONS
INSTRUCT PATIENT IN DAILY HOME MONITORING
SCREENING POSITIONING
WITHIN 3 FEET OF THE READING SCALE AND AT EYE LEVEL
POOR MEASUREMENT TECHNIQUES (CONTROLLABLE)
RAPID DEFLATION OF CUFF, SCREENERS BIAS, IMPAIRED HEARING, USING 4TH PHASE FOR DIASTOLIC READING, MENTAL CONCENTRATION, FAULTY EQUIPMENT AND MISREADING THE MANOMETER
VARIABILITY DUE TO BIOLOGICAL FACTORS
CONTROLLABLE AND UNCONTROLLABLE
CONTROLLABLE
EMOTIONAL STATE, PATIENT POSITION, REST VS EXERCISE, ROOM TEMPERATURE, FULL BLADDER, CIGARETTE SMOKING, AND CAFFEINE INGESTION
UNCONTROLLABLE
EMOTIONAL STATE
FACTORS AFFECTING THE ACCURACY OF
BLOOD PRESSURE MEASUREMENT
POOR HEARING, CUFF SIZE, AND PATIENT POSITIONING
POOR HEARING
IF TUBING IS TOO LONG IT WILL DISTORT SOUNDS, IF THE STETHOSCOPE IS NOT WORN PROPERLY POOR SOUND TRANSMISSION WILL OCCUR
CUFF SIZE
IF THE CUFF SIZE IS TOO SMALL SYSTOLIC AND DIASTOLIC READINGS WILL BE TOO HIGH, IF THE CUFF SIZE IS TOO LARGE BOTH SYSTOLIC AND DIASTOLIC READINGS WILL BE TOO LOW
PATIENT POSITIONING
IF THE PATIENTS ARM IS BELOW HEART LEVEL THE READING WILL BE TOO HIGH, IF THE PATIENTS ARM IS ABOVE HEART LEVEL THE READING WILL BE TOO LOW
KOROTKOFF SOUNDS
SOFT TAP, MURMUR OR SWISHING, HARD TAP, MUFFLING AND DISAPPEARANCE OF SOUND
WAYS TO ACCENTUATE KOROTKOFF SOUNDS
RAPIDLY INFLATE THE CUFF, INFLATE CUFF WHILE THE ARM IS ELEVATED, OPEN AND CLOSE FIST SEVERAL TIMES RAPIDLY AFTER THE CUFF HAS BEEN INFLATED ABOVE THE SYSTOLIC LEVEL
AUSCULTATORY GAP
TEMPORARY DISAPPEARANCE OF SOUND DURING PHASE 2 OR 3, DETERMINING AN APPROPRIATE MAXIMUM INFLATION LEVEL (MIL) CAN REDUCE THIS ERROR
ABSENT FIFTH PHASE
OCCURS WHEN SOUNDS ARE HEARD DOWN TO 0 MM HG OR BELOW THE TRUE DIASTOLIC PRESSURE, THE ONSET OF PHASE 4 SHOULD BE USED TO RECORD THE DIASTOLIC PRESSURE WHEN PHASE 5 IS ABSENT, WHEN THIS OCCURS ALL THREE PHASES SHOULD BE RECORDED AS FOLLOWS: KOROTKOFF1/KOROTKOFF 4/KOROTKOFF 5 (120/50/0
THREE TYPES OF SPHYGMOMANOMETER
MERCURY (MOST ACCURATE), ANEROID(WHAT WE HAVE) AND ELECTRONIC
THE CUFF
CORRECT CUFF SIZE MUST BE USED. A CUFF TOO SMALL WILL GIVE FALSELY HIGH READINGS AND A CUFF TOO LARGE WILL GIVE FALSELY LOW READINGS
PLACEMENT OF THE CUFF
THE BLADDER OF THE CUFF MUST BE CENTERED OVER THE BRACHIAL ARTERY.
STETHOSCOPE
TUBING SHOULD BE 12 -15 INCHES FROM EARPIECE, EARPIECES SHOULD BE INSERTED FORWARD DOWN INTO THE EARS
SYSTOLIC 130 OR LESS DIASTOLIC 80 OR LESS
RECHECK IN 1 - 2 YEARS
SYSTOLIC 130-138, DIASTOLIC 80-88
RECHECK IN 6 - 12 MONTHS
SYSTOLIC 140-158 DIASTOLIC 90 - 98
CONFIRM WITHIN 2 MONTHS
SYSTOLIC 160-178 DIASTOLIC 100 - 108
RECHECK WITHIN 1 MONTH
SYSTOLIC 180-208 DIASTOLIC 110-118
RECHECK WITHIN 1 WEEK
SYSTOLIC 210 OR GREATER, DIASTOLIC 120 OR GREATER
SEND TO EMERGENCY ROOM
PALPATATION
TO FEEL
AUSCULTATION
TO LISTEN
conversion farenheight to celcius
F - 32 x 5/9
conversion celcius to farenheight
C x 9/5 + 32
conversion kg to pounds
1 kg = 2.2 lb
conversion pounds to kg
1 lb = 0.45 kg
oral
98.6 F/37 C
rectal
99.6 F/ 37.6C
Axiillary
97.6 F/ 36.4 C
Pulse sites
temporal, carotid,brachial, apical,radial, femoral,popliteal, dorsalis pedis, and posterior tibial
Body temp is controlled by
hyperthalmus voluntary and involuntary muscle contrations
describe 2 ways a fever will leave the body
crisis and lysis
98.6 F is considered normal temp when taken
orally
most accurate way to measure body temp is
rectal
4 types of fever
continuous-which remains elevated with little to no fluctuation
intermittant-alternatly rises and falls does not return to normal, elevated or subnormal
remittant- temp rises and falls doesn't return to normal until recovery
relapsing- fever that returns after several days of normal temp
list 5 things that may increase body temp
illness, exercise, food intake, heat exposure, pregnancy, emotion, drugs, age(infants have a temp of 1-2 degrees higher than adults)
list 5 things that may decrease body temp
illness (viral infection), activity, fasting, emotions, exposure to cold, drugs, age(elderly have decreased metabolism)
physicians may advise patient to drink plenty of fluids, wear lighter clothing and stop exercising
patient should not be sponged down it may cause shivering
crisis
sudden drop in temperature
lysis
gradual drop in temperature
cover for thermometer
sheeth
name 3 types of thermometers
glass, electric and tympanic
there are 4 ways to take a temperature
typanic, orally, axillary and rectal
how one records any vitals
ex. temp 98.6F, initials, date, time and how
pulse rates adults
60-80 bpm
pulse rates children over 6
70-115 bpm
pulse rates children age 1-6
75-130 bpm
pulse rates infants
110-130 bpm
pulse rates for adults at rest
45-50 bpm
pulse rates for a well fit person
approx. 50 bpm
bradycardia
slower than 60 bpm
tachycardia
faster than 100 bpm
pulse charateristics regular
regular- occurs at even strength & reccurance/time interval between the beats are equal
pulse charateristics irregular
varies in strenght & reoccurance/ take for one full minute
pulse characteristics intermittent
skipping an occasisona beat
volume
strength of beat/ full, strong, feeble, hard,week
thready
weak, rapid rate
bounding
faster than normal, then dissapears
respirations adults
12-20 rpm
respirations children (1 - 6)
20-30 rpm
respirations infants
26-40 rpm
eupnea
normal
bradypnea
slow and under 12 rpm
tachypnea
rapid above 24 rpm
apnea
temporary cessation of breathing
dypnea
difficult breathing
hyperpnea
increased depth of breathing
orthopenea
difficulty in breathing while lying down
cyanosis
bluish skin due to lack of oxygen
anoxia
lack of oxygen
ischemia
lack of oxygen to a body part
respiratory
shallow breathing with only the upper portion of the luings
cheyne-stokes
apnea & dypnea
stertoreus
noisy, such as snorring sounds
abdominal
rales-crackling sound/rhonchi- rattling sounds
try not to alert your patient while you are doing
respirations
height
patient standing on scale backwards and assist off of scale
what is the control center for respiration
medulla oblongata