Primary and Secondary Hypertension (Nursing)

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.