Primary and Secondary Hypertension – Med-Surg Nursing | Lecturio Nursing
Aug 24, 2023
Primary and Secondary Hypertension – Med-Surg Nursing | Lecturio Nursing
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Content
0.18 -> Hi.
1.007 -> Welcome to our video series.
2.636 -> Now, I'm going to talk about
high blood pressure in this one.
5.635 -> The risk factors for it and the
non-pharmacological treatment.
9.445 -> I'm going to give you
a challenge though,
11.098 -> before we start.
12.152 -> Don't tune out.
13.83 -> You may think you already know
15.385 -> everything there is to know
about high blood pressure.
18.175 -> But I really want to encourage you,
20.245 -> this is one area, you can make a
huge impact for your patients.
24.985 -> So the more you know about it, and
how to talk to a patient about it,
29.065 -> you really have the opportunity
to make a difference.
32.665 -> And isn't that why all of us
went into nursing?
35.785 -> So come with me,
hang out,
38.079 -> and let's learn a little bit more
about high blood pressure
40.429 -> and how you can be a
more effective communicator
43.512 -> with your patients.
45.48 -> I know.
46.16 -> So I started out with a chart,
right?
48.21 -> It's okay.
49.105 -> These are numbers
that you need to know
51.024 -> because look at normal,
53.271 -> this is now the new normal.
55.722 -> In order to be considered
a normal blood pressure
58.814 -> not prehypertensive or
heading on your way,
61.345 -> needs to be less than 120 systolic
and less than 80 diastolic.
67.525 -> Okay, that's different
than it's been before.
70.195 -> So you might need
to reset or redefine
72.816 -> how you look at blood pressure.
75.085 -> So make sure
you've got that one down.
76.975 -> Now as you see,
we move on down through the chart.
80.436 -> 120 to 129.
That's elevated.
83.365 -> You see what we define is
84.723 -> High blood pressure
stage one,
86.965 -> High blood pressure
stage two,
89.185 -> and then you're in a
hypertensive crisis.
92.52 -> So most important numbers is to know
normal and hypertensive crisis.
97.836 -> So start with those
98.824 -> and make sure you have the bookends
of knowing what we evaluate
102.222 -> as hypertensive crisis and normal.
107.015 -> Then make sure you go back
and fill in the extra numbers
109.417 -> just to have a frame of reference.
111.175 -> But no, this is a big change.
113.07 -> So a lot of patients
that you may meet may think,
114.636 -> "Oh no, I'm fine because
I'm less than 140."
118.485 -> They're not anymore.
119.406 -> We found with research
120.613 -> that you have increased
risks at 120 and above,
123.715 -> which is why that number
has been adjusted.
126.208 -> Now in healthcare,
127.133 -> it's never enough
just to have one word.
129.175 -> We always have to add
other words to it.
131.755 -> In this case,
133.118 -> primary hypertension is also
known as essential hypertension.
137.52 -> That's just a fancy way of saying,
138.925 -> "We're not exactly sure
what the identifiable cause is
142.314 -> of your high blood pressure."
144.175 -> Now, this tends to develop gradually
over a period of time.
148.366 -> Some people will tell you,
149.628 -> "I can tell when my
blood pressure's elevated."
152.612 -> Not usually.
153.992 -> That's why it's called
"the silent killer."
157.09 -> So it's important that we monitor
and check patient's blood pressure
160.9 -> at regular intervals,
162.202 -> even if they don't have a history
of hypertension.
166.18 -> Now, secondary hypertension,
168.035 -> besides having different words,
169.821 -> a way to remember
it's kind of like secondary,
172.329 -> it's second to something.
174.715 -> So it's caused by an
underlying condition.
177.287 -> Tends to appear more
suddenly than primary.
180.385 -> It also causes higher blood pressure
than does primary hypertension.
184.885 -> So there's various
conditions and medications
187.243 -> that can lead to
secondary hypertension.
190.2 -> Let's just leave it there for now.
192.747 -> Primary not exactly sure
what the identifiable causes.
196.98 -> Secondary, we know what it is.
199.733 -> Pressures tend to be higher
common more suddenly.
202.915 -> And we know what we can probably
attribute it to.
205.998 -> So here's some examples for you just
to kind of file away.
208.92 -> Did you realize that
obstructive sleep apnea
211.767 -> is a cause of
secondary hypertension?
214.59 -> Yeah, so dealing with their snoring
is not the worst problem.
218.61 -> Which if you've ever spent the night
at someone's house who has
221.595 -> obstructive sleep apnea,
223.555 -> it is disturbing.
225.705 -> So not only the
respiratory problems,
228.404 -> it can also cause hypertension
for your patient.
231.943 -> Kidney problems.
232.968 -> Man, the kidneys
are super important
234.912 -> in the controlling of
your blood pressure.
237.145 -> So the patients having
renal problems
238.852 -> are probably likely having
hypertension problems.
241.675 -> You've got an
adrenal gland tumor.
243.715 -> Remember, the adrenal medulla
244.914 -> puts out the norepinephrine,
epinephrine.
246.747 -> So we've got a tumor,
things are going crazy.
249.385 -> That's why you have
elevated blood pressure
251.933 -> and thyroid problems.
253.675 -> I know we all wish we had
a little bit of extra thyroid,
256.5 -> but really, thyroid problems can
cause problems with blood pressure.
261.3 -> Now there can be people with certain
defects that you're born with.
263.729 -> They call those congenital.
They came with you.
266.602 -> So you might have
some congenital defects
268.214 -> in the blood vessels.
269.46 -> There's medications like
birth control pills, cold remedies,
273.265 -> decongestants is a big one.
275.635 -> There's also some
over the counter pain relievers
277.533 -> and some prescription drugs
that can be problematic.
280.435 -> Let me go back up to decongestants.
283.47 -> If you already have a propensity
285.026 -> to have a little bit
higher blood pressure,
287.545 -> decongestants are out.
290.081 -> Unless they're specific
for cardiac patients,
292.765 -> keep that in mind,
294.067 -> because those can
raise your blood pressure.
297.96 -> Now lastly,
298.865 -> I hope this isn't a a group
that you have experience with,
301.555 -> but cocaine and amphetamines
can also cause hypertension.
306.085 -> Fact a worst case scenario
for a cocaine overdose is,
309.211 -> boom,
310.11 -> cardiovascular.
311.82 -> And we say like the heart
just blew up.
313.525 -> That's a little dramatic
but its really, really hard
316.239 -> on the cardiovascular system.
Source: https://www.youtube.com/watch?v=3B5FeVHG6yw
