Primary and Secondary Hypertension (Nursing)

by Rhonda Lawes

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    00:00 Hi.

    00:01 Welcome to our video series.

    00:03 Now, I'm going to talk about high blood pressure in this one.

    00:06 The risk factors for it and the non-pharmacological treatment.

    00:09 I'm going to give you a challenge though, before we start.

    00:12 Don't tune out.

    00:14 You may think you already know everything there is to know about high blood pressure.

    00:18 But I really want to encourage you, this is one area, you can make a huge impact for your patients.

    00:25 So the more you know about it, and how to talk to a patient about it, you really have the opportunity to make a difference.

    00:33 And isn't that why all of us went into nursing? So come with me, hang out, and let's learn a little bit more about high blood pressure and how you can be a more effective communicator with your patients.

    00:45 I know.

    00:46 So I started out with a chart, right? It's okay.

    00:49 These are numbers that you need to know because look at normal, this is now the new normal.

    00:56 In order to be considered a normal blood pressure not prehypertensive or heading on your way, needs to be less than 120 systolic and less than 80 diastolic.

    01:08 Okay, that's different than it's been before.

    01:10 So you might need to reset or redefine how you look at blood pressure.

    01:15 So make sure you've got that one down.

    01:17 Now as you see, we move on down through the chart.

    01:20 120 to 129. That's elevated.

    01:23 You see what we define is High blood pressure stage one, High blood pressure stage two, and then you're in a hypertensive crisis.

    01:33 So most important numbers is to know normal and hypertensive crisis.

    01:38 So start with those and make sure you have the bookends of knowing what we evaluate as hypertensive crisis and normal.

    01:47 Then make sure you go back and fill in the extra numbers just to have a frame of reference.

    01:51 But no, this is a big change.

    01:53 So a lot of patients that you may meet may think, "Oh no, I'm fine because I'm less than 140." They're not anymore.

    01:59 We found with research that you have increased risks at 120 and above, which is why that number has been adjusted.

    02:06 Now in healthcare, it's never enough just to have one word.

    02:09 We always have to add other words to it.

    02:12 In this case, primary hypertension is also known as essential hypertension.

    02:18 That's just a fancy way of saying, "We're not exactly sure what the identifiable cause is of your high blood pressure." Now, this tends to develop gradually over a period of time.

    02:28 Some people will tell you, "I can tell when my blood pressure's elevated." Not usually.

    02:34 That's why it's called "the silent killer." So it's important that we monitor and check patient's blood pressure at regular intervals, even if they don't have a history of hypertension.

    02:46 Now, secondary hypertension, besides having different words, a way to remember it's kind of like secondary, it's second to something.

    02:55 So it's caused by an underlying condition.

    02:57 Tends to appear more suddenly than primary.

    03:00 It also causes higher blood pressure than does primary hypertension.

    03:05 So there's various conditions and medications that can lead to secondary hypertension.

    03:10 Let's just leave it there for now.

    03:13 Primary not exactly sure what the identifiable causes.

    03:17 Secondary, we know what it is.

    03:20 Pressures tend to be higher common more suddenly.

    03:23 And we know what we can probably attribute it to.

    03:26 So here's some examples for you just to kind of file away.

    03:29 Did you realize that obstructive sleep apnea is a cause of secondary hypertension? Yeah, so dealing with their snoring is not the worst problem.

    03:39 Which if you've ever spent the night at someone's house who has obstructive sleep apnea, it is disturbing.

    03:46 So not only the respiratory problems, it can also cause hypertension for your patient.

    03:52 Kidney problems.

    03:53 Man, the kidneys are super important in the controlling of your blood pressure.

    03:57 So the patients having renal problems are probably likely having hypertension problems.

    04:02 You've got an adrenal gland tumor.

    04:04 Remember, the adrenal medulla puts out the norepinephrine, epinephrine.

    04:07 So we've got a tumor, things are going crazy.

    04:09 That's why you have elevated blood pressure and thyroid problems.

    04:14 I know we all wish we had a little bit of extra thyroid, but really, thyroid problems can cause problems with blood pressure.

    04:21 Now there can be people with certain defects that you're born with.

    04:24 They call those congenital. They came with you.

    04:27 So you might have some congenital defects in the blood vessels.

    04:29 There's medications like birth control pills, cold remedies, decongestants is a big one.

    04:36 There's also some over the counter pain relievers and some prescription drugs that can be problematic.

    04:40 Let me go back up to decongestants.

    04:43 If you already have a propensity to have a little bit higher blood pressure, decongestants are out.

    04:50 Unless they're specific for cardiac patients, keep that in mind, because those can raise your blood pressure.

    04:58 Now lastly, I hope this isn't a a group that you have experience with, but cocaine and amphetamines can also cause hypertension.

    05:06 Fact a worst case scenario for a cocaine overdose is, boom, cardiovascular.

    05:12 And we say like the heart just blew up.

    05:14 That's a little dramatic but its really, really hard on the cardiovascular system.

    About the Lecture

    The lecture Primary and Secondary Hypertension (Nursing) by Rhonda Lawes is from the course Hypertension (Nursing).

    Included Quiz Questions

    1. Systolic less than 120 mm Hg and diastolic less than 80 mm Hg
    2. Systolic of 120–129 mm Hg and diastolic less than 80 mm Hg
    3. Systolic of 130–139 mm Hg or diastolic of 80–89 mm Hg
    4. Systolic of 140–179 mm Hg or diastolic of 90–120 mm Hg
    1. Hypertension without an obvious cause
    2. All cases of hypertension are primary hypertension
    3. Hypertension caused by another disease process
    4. Hypertension that develops suddenly
    1. Secondary hypertension
    2. Primary hypertension
    3. Profound hypotension
    4. Renal insufficiency

    Author of lecture Primary and Secondary Hypertension (Nursing)

     Rhonda Lawes

    Rhonda Lawes

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