HYPERTENSION y > 140 mmHg- Systolic y >90 mmhg Diastolic Pulse Pressure- difference between systolic and diastolic

Systolic- diastolic= Pulse Pressure Difference should be only 30 -40 mmHg Target Organs: 1.) Heart y Myocardial infarction, CHF, myocardial hyperthropy, dysrhytmia 2.) Eyes y Blurred/ impaired vision, retinopathy, cataract 3.) Brain y CVA, encephalopathy 4.) Kidneys y Renal insufficiency, renal failure 5.) Peripheral Blood Vessels y Dissecting aneurysm, gangrene Classifications: 1.) Essential/ Idiopathic/Primary Hypertension y 90 95 % of all causes of HTN y Cause is unknown 2.) Secondary HTN y Known causes (e.g. Renal failure) 3.) Malignant HTN y Severe, rapidly progressive elevation in BP that causes rapid onset end organ complications. 4.) Labile HTN y Intermittently BP 5.) Resistant HTN y Does not respond to usual treatment 6.) White coat HTN y Elevation of BP during clinic visit 7.) Hypertensive crisis y Immediate BP lowering ( w.in 1 systolic > 240 mmHg, diastolic > 120 mmHg) KOROTKOFF SOUNDS PHASE 1- thump, thud, tapping sounds; at least 2 consecutive sounds should be heard to eliminate extraneous sounds ( SYSTOLIC BP). PHASE 2- swooshing, whooshing sound PHASE 3- lower in intensity when compared to Phase I. PHASE 4- softer, blowing, muffled sound that fades ( PEDIATRIC DIASTOLIC BP) PHASE 5- last sound, disappearance of the sound ( ADULT DIASTOLIC BP) 1-2 mins- rechecking of blood pressure. Stethoscope 1. DiapHragm S1, S2 - High pitch sound, e.g. Bowel sound -breath sounds 2. BeLL- S3, S4 - Low pitch sound -BLood Pressure Cuff should be appropriate to patient s arm FALSE low FALSE high - Cuff is too wide - Cuff is too narrow -Arm is higher at heart level - Arm is lower than heart level -Deflating is too quick - Deflating is too slow