Homeostatic Imbalances: Hypertension, Hypotension, and Shock (Nursing)

00:01 We also have transient elevations in our blood pressure that occur when we change posture.

00:07 As well as through physical exertion, emotional upset, or when we have a fever.

00:13 In 2017, new blood pressure categories were established based on the guidelines of the American College of Cardiology, and the American Heart Association. These categories refer to office-based measurements.

00:26 Normal blood pressure is now defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80 millimeters of mercury.

00:34 An elevated blood pressure, or “prehypertension,” is a systolic pressure of 120 to 129 and a diastolic pressure of less than 80. Stage 1 hypertension is a systolic pressure of 130 to 139 OR a diastolic pressure of 80 to 89 millimeters of mercury. Stage 2 hypertension is a systolic pressure of at least 140 and a diastolic pressure of at least 90. Note that most countries other than the United States continue to define hypertension as a systolic pressure of 140 or more or a diastolic pressure of 90 or more millimeters of mercury.

01:12 A person is considered prehypertensive, if the values are elevated but are not all the way up to what we consider the hypertension range.

01:22 Prehypertension may be due to transient adaptations during a fever, or physical exertion, or emotional upset.

01:32 But they can also be persistent in patients with obesity Hypertension is going to be prolonged hypertension and as the major cause of heart failure, vascular disease, renal failure, and stroke.

01:46 This is because the heart must work harder, and therefore, the myocardium enlarges, and gets weaker and becomes flabby.

01:55 This can also accelerate the process of atherosclerosis or the building up of fatty plaques in our blood vessels.

02:05 Primary hypertension is going to account for 90% of our hypertensive conditions.

02:14 Usually there's no underlying cause that is identified.

02:18 Risk factors include genetics, race, diet, obesity, age, diabetes mellitus, stress, and smoking There's no cure for primary hypertension, but it can be controlled by restricting salts, fats, and cholesterol in the diet, increasing exercise and losing weight and also stopping smoking or by antihypertensive drugs.

02:41 Secondary hypertension is less common and is usually due to identifiable disorders including an obstructed renal artery, kidney disease, and endocrine disorders such as hyperthyroidism and Cushing's syndrome.

02:57 The treatments for secondary hypertension usually involve treating the underlying cause instead of treating the hypertension itself.

03:06 Hypotension is low blood pressure.

03:11 And is usually considered low when your blood pressure is 90/60 mm Hg or lower.

03:18 Hypotension is usually not a concern, unless it leads to an inadequate blood flow to your tissues.

03:26 And actually, hypotension has been associated with longer life and in lack of cardiovascular illnesses.

03:35 There are different types of hypotension.

03:39 We have orthostatic hypotension, which is a temporary low blood pressure and dizziness when you suddenly rise from sitting or from a reclining position, such as when you stand up too fast.

03:52 Then we have chronic hypotension.

03:55 This usually hints at poor nutrition and could be warning signs for other diseases, such as Addison's disease or hypothyroidism.

04:05 Acute hypotension is usually going to be an important sign of circulatory shock.

04:13 So what is circulatory shock? This is a condition where our blood vessels are going to inadequately fill and therefore cannot circulate our blood normally through the body.

04:23 This inadequate blood flow then cannot meet our tissues needs.

04:29 Another type of shock is hypovolemic shock.

04:33 This results from large scale blood loss such as during a hemorrhage.

04:38 We also have vascular shock.

04:42 This results from extreme vasodilation and decrease peripheral resistance.

04:48 And finally, we have cardiogenic shock, which results when an inefficient heart cannot sustain adequate circulation.