Which advice regarding modifiable risk factors would the nurse give to a patient who has a BP of 150 100 mm Hg select all that apply?

Blood pressure is the force of blood pushing against your artery walls. High blood pressure (HBP), also known as hypertension, means the pressure in your arteries is higher than it should be. Hypertension can develop over many years without showing any signs or symptoms; however, throughout this time, damage is being done to your overall health. Thus giving this condition the nickname “silent killer.” Hypertension can be identified as primary (without a known cause) or secondary (having an underlying condition as its cause).

Hypertension increases the workload of your heart and blood vessels. Over time, this workload leads to the damage of your artery walls. In turn, LDL (bad) cholesterol forms plaque along these damaged walls. Plaque build-up is a condition known as atherosclerosis. As plaque accumulates, the narrower the insides of the arteries become, leading to not only higher blood pressure, but signifies the beginning of a cycle that will further damage your heart and the rest of your body.

Causes of High Blood Pressure

Although the exact cause is unknown, certain conditions, traits or habits may raise your risk for the condition. These are known as risk factors and include:

Non-modifiable risk factors: These factors are irreversible and cannot be changed. The more of these risk factors you have, the greater your chance of developing HBP.

• Starting at age 18, ask your doctor for a blood pressure reading at least every two years. If you're age 40 or older, or you're 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.
• Family history/Genetics
• African Americans and non-white Hispanic Americans are at higher risk for developing high blood pressure than any other group in the U.S.

Modifiable risk factors: These factors can be modified, treated or controlled through medications or lifestyle changes.

• Excessive alcohol consumption over many years.
• Little to no physical activity
• Excessive amounts of salt in diet that excess the recommended amounts of 1,500 to 2,300 mg of sodium per day.
• Long history of smoking and/or drug abuse
• Extreme emotional stress

Other conditions that contribute to developing high blood pressure

• Aldosteronism: a condition in which there is excessive secretion of aldosterone which disturbs the balance of sodium, potassium, and water in the blood leading to high blood pressure.
• End-stage renal disease: a condition in which your kidneys have stopped working well and your body retains fluid.
• Thyroid disease: a condition that is caused by the over or under function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintains the body’s metabolism.
• Obstructive sleep apnea: a condition in which your breathing abruptly stops and starts while sleeping.
• Certain medications such as cough, cold, inflammation and migraine/headache medications.

Symptoms of High Blood Pressure

Most people with high blood pressure have no signs or symptoms. However, once blood pressure reaches a certain level, symptoms begin to show:

• Blurry or double vision
• Lightheadedness/Fainting
• Fatigue
• Headache
• Heart palpitations
• Nosebleeds
• Shortness of breath
• Nausea and/or vomiting

*Anybody who experiences these symptoms should see their doctor immediately.

Diagnosis of High Blood Pressure

The best way to diagnose HBP is to have it measured. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers.

• Systolic blood pressure (the top number) indicates how much pressure your blood is exerting against your artery walls during heartbeats.
• Diastolic blood pressure (the bottom number) indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Blood pressure measurements fall into four general categories. The American Heart Association’s guidelines are as follow:

• Normal blood pressure: A reading of less than 120 (systolic) and 80 (diastolic)
• Elevated blood pressure: A reading ranging from 120 to 129 (systolic) and below 80 (diastolic)
• Stage 1 hypertension: A reading ranging from 130 to 139 (systolic) or 80 to 89 (diastolic)
• Stage 2 hypertension: A reading ranging from 140 or higher (systolic) or 90 (diastolic)
• Hypertensive crisis (consult your doctor immediately): A reading higher than 180 (systolic) and/or 120 (diastolic)

*If you have an electronic blood pressure machine and would like to measure your blood pressure at home, please follow The American Heart Association’s guidelines:

• Don't smoke, drink caffeinated beverages or exercise within 30 minutes before measuring your blood pressure.
• Empty your bladder and ensure at least 5 minutes of quiet rest before measurements.
• Sit with your back straight and supported (on a dining chair, rather than a sofa). Your feet should be flat on the floor and your legs should not be crossed. Your arm should be supported on a flat surface (such as a table) with the upper arm at heart level. Make sure the bottom of the cuff is placed directly above the bend of the elbow. Check your monitor's instructions for an illustration or have your healthcare provider show you how to do it.
• It’s important to take the readings at the same time each day, such as morning and evening .
• Take multiple readings and record the results. Each time you measure, take two or three readings one minute apart and record the results.
• Don't take the measurement over clothes.

Treatment of High Blood Pressure

Treatment for HBP depends on its severity and associated risks of developing other diseases. Treatment options include:

Lifestyle changes

• Avoid smoking
• Eat a heart-healthy diet, especially one that is low in salt.
• Exercise under the directions of your doctor.
• If you’re overweight, talk to your doctor about weight-loss options.
• Limiting alcohol consumption to 1 drink per day for women and 2 drinks per day for men.
• Manage stress
• Make and keep appointments to see your doctor for routine check-ups and follow-up tests.

Medications

• ACE inhibitors will help blood vessels relax and open up, leading to a lower blood pressure.
• Angiotensin II receptor blockers will help blood vessels open up, leading to a lower blood pressure.
• Beta blockers will help reduce your blood pressure.
• Alpha blockers will help reduce the arteries’ resistance, relaxing the muscle tone of the vascular walls.
• Alpha-2 receptor agonists will help reduce blood pressure by decreasing the activity of the sympathetic portion of the involuntary nervous system.
• Calcium channel blockers will help relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
• Combined alpha and beta blockers are used as an IV drip for those patients experiencing a hypertensive crisis.
• Central agonists will help decrease the blood vessels’ ability to tense up or contract.
• Diuretics “water pills” will help reduce the amount of fluid retention in your body.
• Peripheral adrenergic inhibitors will help reduce blood pressure by blocking neurotransmitters in the brain.
• Vasodilators will help the muscle in the walls of the blood vessels to relax, allowing the vessel to dilate.

Which advice regarding modifiable risk factors would the nurse give to a patient who has a BP of 150 100 MMHG select all that apply?

Which of the following are considered modifiable risk factors for heart disease Select all that apply?

What modifiable risk factors should be included in education for a patient at risk for development of atherosclerosis?

What are the modifiable and non