Risks of High Blood Pressure (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 So, what's the big deal if my blood pressure is a little high? Well, I want you to write down 6 very important things.

    00:09 Now, we've got them on the slide there.

    00:11 So if you'll just number them as we go through, put some type of marking for yourself, because these are really important.

    00:17 These are things that you should be educating patients about all the time.

    00:22 You want to do it in a kind way.

    00:24 But see, when your blood pressure is high, you don't always know it.

    00:27 Some people think they can always tell when their blood pressure is high.

    00:30 But really, we call it "the silent killer" for a reason.

    00:34 Now, let's start at the top and work our way down.

    00:37 High blood pressure can put you at increased risk for events like strokes and heart attacks.

    00:43 It can also severely damage your eyes.

    00:46 So there's the first 3 reasons: stroke, vision loss, or heart attack.

    00:53 Sometimes, you see the word for heart attack as myocardial infarction, but they mean the same thing.

    01:00 Now, the heart can also be thrown into heart failure, and I want to walk you through that just a little bit.

    01:06 The reason heart failure becomes a problem, let's think back; what are the 2 components of blood pressure? Right, cardiac output and systemic vascular resistance.

    01:21 So, why…how does high blood pressure cause heart failure? Well, remember what SVR is? The force that heart has to push against the blood back out to the body, right? So we're talking right after that left ventricle.

    01:36 The higher that SVR is over a period of time, the harder that heart has to work.

    01:42 So, initially, what the heart does is like, "Oh, I'll show you.

    01:45 I'm gonna get bigger and stronger, and bigger and stronger, and bigger and stronger." And finally…we call that cardiac remodeling… the bigger and stronger part gets way out of control, and the heart becomes kind of floppy and mushy.

    01:57 And that's what causes…1 of the causes of congestive heart failure.

    02:02 When someone has prolonged hypertension, prolonged high blood pressure, that heart has had to work so very hard, that it just gets overworked.

    02:13 That muscle gets big and floppy and mushy and not effective anymore.

    02:17 So that's why high blood pressure can cause heart failure.

    02:21 Now, I already talked about heart attack and stroke.

    02:24 And remember, we talked about people with high blood pressure often already have plaque, too.

    02:29 So, that's another issue where that plaque can break off and it can land in your heart, the blood supply of your heart, cause a heart attack, or a myocardial infarction.

    02:37 It can land in your head and cause a stroke.

    02:40 Now, the other 2 things aren't any fun, either.

    02:43 But high blood pressure just really beats up on your kidneys, right? They weren't made to just be boom, boom, boom, boom, boom, boom, boom, to just be beat with a really high blood pressure.

    02:54 So, high blood pressure damages your kidneys.

    02:57 You'll start to see protein showing up in their urine, and some early signs of the kidneys are really struggling as that first begins.

    03:05 And the last one is no fun either, because it usually deals with sexual dysfunction.

    03:09 So we've got 6 things here.

    03:12 I want you to stop and pause and think, "What's going to be the best way for you to keep in mind these 6 things?" I like to go from head to toe, but you can group them however you want.

    03:22 But I want you to keep in mind that you should be able to quickly and easily recall these 6 main risks of high blood pressure.

    03:31 Please be sure that you can explain how heart failure is caused by high blood pressure, why kidneys fail because of high blood pressure, what role does plaque play in high blood pressure, and stroke, and heart attack? Now, let's talk about the actual numbers, the nitty gritty of how we define blood pressure.

    03:52 It may surprise you how we now define blood pressure.

    03:56 Normal used to be 120/80, but now they're making it even stricter.

    04:01 So, now they want normal to be < 120 and < 80, so that's considered a normal blood pressure.

    04:10 Elevated blood pressure…and I'm going to give you 5 different categories of blood pressure.

    04:16 So normal, < 120; elevated, 122-129, but your diastolic is still < 80.

    04:25 High blood pressure, that we call stage 1 hypertension, a systolic… a systolic blood pressure of 130/139, or diastolic blood pressure that's now higher…look at that, it's 80-89.

    04:40 So, if a patient meets these criteria, we consider them to have stage 1 hypertension.

    04:47 High blood pressure or hypertension stage 2 is a systolic blood pressure 140 or higher.

    04:54 See, that used to be the number that people… if they hit 140, they're like, "I don't really have high blood pressure." Yeah, you're at stage 2 now with these different categories.

    05:03 And if you're a diastolic, pressure is 90 or higher, you're definitely at stage 2 hypertension.

    05:12 Now, this one is considered a hypertensive crisis, and you would be amazed at how many people experience this.

    05:20 That's a systolic pressure higher than 180, and the diastolic pressure higher than 120.

    05:28 And have I seen this? Yes.

    05:30 And did it get my attention? Absolutely.

    05:34 I was so afraid my patient was gonna have some major type event.

    05:39 So, normal, you don't need any more follow up except just to kind of consistently check it to make sure it's okay.

    05:44 Elevated, it's time to start doing some things.

    05:47 It's time for lifestyle changes and to let your physician know.

    05:50 Talk to your healthcare provider and look what you can do.

    05:53 At hypertension stage 1, you definitely have a problem now, so this really is serious.

    05:58 Stage 2, for sure you're on medications, but for the hypertensive crisis, circle that, underline it, do whatever you need to do because those numbers say your patient is in danger right now.

    06:13 They need to get to the hospital immediately for treatment.

    About the Lecture

    The lecture Risks of High Blood Pressure (Nursing) by Rhonda Lawes, PhD, RN is from the course Pharmacology and Implications for Nursing. It contains the following chapters:

    • Risks of High Blood Pressure
    • Blood Pressure Categories

    Included Quiz Questions

    1. High blood pressure
    2. Low systemic vascular resistance
    3. Elevated cardiac output
    4. Hypotension
    1. Protein
    2. Leukocytes
    3. Urea
    4. Glucose
    1. Stage 2 hypertension
    2. Normal
    3. Elevated
    4. Stage 1 hypertension

    Author of lecture Risks of High Blood Pressure (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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