Back to FlashcardsNursing / Simmons NURP 502 Exam 1 2: Adult HTN Management
What is the treatment for pre-HTN?
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Key Terms
Term
Definition
What is the treatment for pre-HTN?
Lifestyle modifications
What is the treatment for Stage 1 HTN?
• Lifestyle modifications • Thiazide diuretic (for most) • Can consider ACEs, ARBs, BBs, CCBs, or combination
What is the treatment for Stage 2 HTN?
• Lifestyle modifications • 2-drug combo • Usually thiazide diuretic + ACE, ARB, BB, or CCB
What lifestyle changes are recommended in HTN?
• Weight reduction or maintenance • DASH diet and sodium reduction • Total sodium per day should not exceed 2,400 mg • Goal of 2,000 mg • Increase phy...
When is pharm treatment initiated in HTN?
• Healthy 60+ (no DM or CKD) = >150/90 • Everyone else = >140/90
In the population aged 18+ with CKD, when is pharm treatment initiated?
>140/90 (Grade E)
Related Flashcard Decks
| Term | Definition |
|---|---|
What is the treatment for pre-HTN? | Lifestyle modifications |
What is the treatment for Stage 1 HTN? | • Lifestyle modifications • Thiazide diuretic (for most) • Can consider ACEs, ARBs, BBs, CCBs, or combination |
What is the treatment for Stage 2 HTN? | • Lifestyle modifications • 2-drug combo • Usually thiazide diuretic + ACE, ARB, BB, or CCB |
What lifestyle changes are recommended in HTN? | • Weight reduction or maintenance • DASH diet and sodium reduction • Total sodium per day should not exceed 2,400 mg • Goal of 2,000 mg • Increase physical activity • Thirty minutes of brisk exercise most days of the week • Moderate alcohol consumption • ≤2 drinks per day for men • ≤1 drink a day for women and lighter weight individuals •Smoking cessation |
When is pharm treatment initiated in HTN? | • Healthy 60+ (no DM or CKD) = >150/90 • Everyone else = >140/90 |
In the population aged 18+ with CKD, when is pharm treatment initiated? | >140/90 (Grade E) |
What is a Grade B recommendation for 18+ with CKD? | HTN treatment should include an ACE or ARB regardless of race or DM status. |
What is the main objective of HTN treatment? | To attain and maintain goal BP. |
When do you change the drug treatment? | If goal is not reached within a month of treatment, increase the dose or add a second drug. |
What 2 anti-HTN drugs are contraindicated to be used together? | ACEs and ARBs |
Excluding HTN with CKD, what is initial treatment choice for all other types of HTN? | • Nonblack = Initiate thiazide or ACE, ARB, or CCB alone or in combination. • Black = Initiate thiazide or CCB, alone or in combination. |
T/F Treating HTN in 60+ patients with a goal of 130/80 increases survivability. | False. Aggressively treating hypertension in >60 patients with a goal of 130/80 mm Hg does not increase survivability or comorbidity, but in fact causes health problems from drugs. |
Name 3 drug treatment titration strategies for HTN according to JNC 8. | 1. Maximize first medication before adding second. 2. Add second medication before reaching maximum dose of first medication. 3. Start with 2 medication classes separately as a fixed-dose combination. |
If goal BP is not met after increasing med or adding 2nd med, what is the next step? | 1. Add and titrate thiazide or ACE or CCB (use med class not previously selected). 2. If already on 2 meds, max doses of initial 2 meds. 3. If still not met, add medication class not previously used (ACE, ARB, CCB). 4. If still not met, add additional med class (BB, aldosterone antagonist, or other) and/or refer to specialist. |
If starting a patient on a thiazide or ACEI, what would be the dose? | • HCTZ = 25 mg • ACE = 10-20 mg |