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Lecture 15

NUR 239 Lecture Notes - Lecture 15: Vascular Resistance, Chronic Kidney Disease, Coronary Artery Disease

Mennonite College of Nursing
Course Code
NUR 239
Yvette Pigman

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NUR 239/Pathophysiology and Pharmacotherapeutics in Nursing I
Unit 3/Drug Therapy for Hypertension
Complete the following study guide and submit on Reggie Net by the due date on the Course Calendar
You should have an understanding of all the key terms at the beginning of each Chapter.
Key Learning Objectives - Answer the follow questions (Chapter 26 - Drug Therapy for Hypertension):
How is BP regulated?
o Homeostatic mechanisms that adjust blood flow to meet tissue needs. Arterial blood pressure is
cardiac (systolic) and peripheral vascular resistance (diastolic).
Name the two factors that determine arterial blood pressure.
o Cardiac and peripheral vascular resistance
Explain the following equation: CO = HR x SV
o CO equals the product of the HR and SV. Stroke volume is the amount of blood ejected with each
heartbeat. CO depends on the force of myocardial contraction, blood volume, etc.
What is vascular tone?
o Degree of constriction or dilation in arterioles and arteries (vascular tone)
Describe autoregulation of blood flow.
o Ability of body tissues to regulate their own blood flow. Major organs like the heart, brain, and
kidney need to preserve oxygen and function. Thus, local blood flow is regulated by nutritional
needs such as oxygen or accumulation of CO2 and lactic acid. Vasoconstriction and dilating
substances regulate local blood flow.
What factors influence local blood flow to tissues?
o Histamine, bradykinin, serotonin, and prostaglandins
Describe the vasoactive substances that produced by the endothelial cells.
o Vasoconstriction increase vascular tone and blood pressure. Vasodilation decrease vascular tone
and blood pressure.
When an excessive amount of vasoconstriction substances is produced, what are potential conditions may
o May lead to the development of atherosclerosis, HTN, and other diseases.
Which part of the autonomic nervous system is involved in BP regulation?
o Sympathetic nervous system
Define hypertension.
o Persistently high BP that exceeds this level and results from abnormalities in regulatory
Describe the pathophysiology of hypertension.
o Alter cardiovascular function by increasing the workload of the heart and causing thickening and
sclerosis of arterial walls
Define the goal of treatment for hypertension.
o In patients aged 60 or older, without diabetes or chronic kidney disease, the treatment goal is BP
of less than 150/90.
o In patients 18-59 who are in general good health and patients 60 years or older with diabetes of
chronic kidney disease, the goal is BP less than 140/90
o Lowering to any extent can decrease the incidence of coronary artery disease and stroke.
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