10 minute topic Heart failure Flashcards

1
Q

Heart failure

A

cardiac muscle is unable to pump effectively and unable to maintain adequate circulation to meet tissue needs

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2
Q

Result of HF

A

inadequate cardiac output
myocardial hypertrophy
pulmonary/systemic congestion

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3
Q

Causes of HF

A

can be acute or chronic

HTN, MI, Pulmonary HTN, dysrhythmias, valve disease, pericarditis, cardiomyopathy

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4
Q

Class I HF

A

Client exhibits no symptoms with activity

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5
Q

Class II HF

A

Client has symptoms with ordinary exertion

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6
Q

Class III HF

A

Client displays symptoms with minimal exertion

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7
Q

Class IV HF

A

Client has symptoms at rest (SOB and chest pain at rest)

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8
Q

Low-output heart failure

A

can initially occur on either the left or right side of the heart

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9
Q

Left sided (ventricular) HF

A

results in inadequate left ventricle (cardiac) output and inadequate tissue perfusion

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10
Q

Systolic failure

A

ejection fraction below 40%, pulmonary and systemic congestion

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11
Q

Diastolic failure

A

inadequate relaxation or “stiffening” prevents ventricular filling

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12
Q

Right Sided (ventricular) HF

A

inadequate right ventricle output and systemic venous congestion (peripheral edema)

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13
Q

Risk Factors for Left-sided (ventricular) HF (left = lungs)

A
Hypertension
Coronary artery disease
Angina
MI
Valvular disease (mitral and aortic)
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14
Q

Risk Factors for right-sided (ventricular) HF

A

Left-sided heart (ventricular) failure – it backs up to the right
Right ventricular MI
Pulmonary problems (COPD, pulmonary fibrosis)

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15
Q

Risk factors for high output HF

A

Increased metabolic needs
Septicemia (fever)
Anemia
Hyperthyroidism

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16
Q

Risk factors for cardiomyopathy

A
Coronary artery disease
Infection or inflammation of the heart muscle
Various cancer treatments (cause) 
Prolonged alcohol use
Heredity
17
Q

Cardiomyopathy sx

A
Fatigue 
Weakness
Heart failure
Heart block 
Gallop
Cardiomegaly
18
Q

Human B-type natriuetic peptides (hBNP)

A

used to Dx HF from other respiratory problems and to monitor effectiveness of tx

19
Q

Human B-type natriuetic peptides (hBNP) levels

A

100 < 300 pg/mL suggest HF is present.
> 300 pg/mL indicates mild HF
> 600 pg/mL indicates moderate HF
> 900 pg/mL indicates severe HF

20
Q

Hemodynamic monitoring

A

done in the ICU to dx HF

21
Q

Cardiac ultrasound or ECG

A

measures both systolic & diastolic function of the heart

22
Q

Left ventricular ejection fraction (LVEF)

A

The volume of blood pumped from the left ventricle into the arteries upon each beat. Normal is 55% to 70%

23
Q

Right ventricular ejection fraction (RVEF)

A

The volume of blood pumped from the right ventricle to the lungs upon each beat. Normal is 45% to 60%.

24
Q

HF nursing care

A

Position to maximize ventilation (high fowlers, sit them up)
Bedrest until stable
Fluid and Na+ restrictions
Provide O2

25
HF medications
``` preload and afterload reducing agents Inotropic agents Vasodilators Anticoagulants hBNP ```
26
Medication to reduce preload
diuretics
27
Medication to reduce afterload
ACE inhibitors, ARBs to help the heart pump more easily by altering the resistance to the contraction
28
Inotropic agents
digoxin which will increase contractility and increase cardiac output
29
Vasodilators
will help to reduce preload and afterload and decrease myocardial demand (Nitro)
30
Anticoagulants
Coumadin – especially if they have a history of thrombus formation
31
nesiritide (Natrecor)
hBNP | used to treat acute HF, it causes natriuresis (loss of NA and vasodilation)
32
hBNP – nesiritide (Natrecor)nursing considerations,
hypotension, VT & bradycardia – on monitor & close VS monitoring BNP levels will rise while on med Give in separate IV d/t incompatibility with other meds (HEPARIN)
33
Ventricular assist device (VAD)
surgically implanted mechanical pump that assists a heart that is too weak to pump blood through the body.
34
Heart transplantation
End stage HF patients get this The new hearts will often develop CAD Will need increased K+ intake