FLUID-GAS TRANSPORT
Conditions Affecting Fluid Transport

  1. Hypertension: sustained, elevated, systemic, arterial blood pressure; diastolic elevation more serious, reflecting pressure on arterial wall during resting phase of cardiac cycle (Table 7-3).
    1. Pathophysiology: increased peripheral resistance leading to thickened arteriole walls and left ventricular hypertrophy.
    2. Risk factors:
      1. Black race (2:1).
      2. Use of birth control pills.
      3. Overweight.
      4. Smoking.
      5. Stress.
      6. Excessive sodium intake or saturated fat.
      7. Lack of activity.
    3. Classifications:
      1. Essential (primary or idiopathic): occurs in 90 - 95% of patients; etiology unknown; diastolic pressure is 2:90 mm Hg, and other causes of hypertension are absent. Benign hypertension (diastolic pressure ^120 mm Hg) considered controllable; asymptomatic until complications develop.
      2. Secondary: occurs in remaining 5 - 10%; usually renal, endocrine, neurogenic, or cardiac in origin.
      3. Malignant hypertension (systolic >140 - 150 mm Hg); uncontrollable. May arise from both types.
      4. Labile (prehypertensive): a fluctuating blood pressure; increases during stress, otherwise normal or near normal.
    4. Assessment:
      1. Subjective data:
        1. Early-morning headache, usually occipital.
        2. Light-headedness, tinnitus.
        3. Palpitations.
        4. Fatigue, insomnia.
        5. Forgetfulness, irritability.
        6. Altered vision: white spots, blurring, or loss.
      2. Objective data:
        1. Epistaxis (nosebleeds).
        2. Elevated blood pressure: systolic >140 mm Hg, diastolic >90 mm Hg; narrowed pulse pressure. Rise in diastolic from sit-