Agents for Treating Heart Failure - General

Question 1

Congestive heart failure

Answer 1

• Condition in which the heart fails to effectively pump blood throughout the body
• Primary treatment: allows the heart muscle to contract more efficiently in an effort to bring the system back into balance

Question 2

Causes of CHF

Answer 2

-HF can occur with any of the disorders that damage or overwork the heart muscle: CAD, HTN, cardiomyopathy, valvular heart disease

Question 3

Underlying problems in HF

Answer 3

• Muscle damage: atherosclerosis or cardiomyopathy
• Increase in workload to maintain an efficient output: HTN or valvular disease
• Structural abnormality: Congenital heart defects

Question 4

Compensatory mechanisms

Answer 4

• Decreased CO: sympathetic stimulation, release of renin

- Cellular changes

Question 5

S/S of Right-sided HF

Answer 5

• Elevated jugular venous pressure
• Splenomegaly
• Hepatomegaly
• Nocturia
• Pitting edema
• Weakness/fatigue

Question 6

S/S of Left-sided HF

Answer 6

• Anxiety
• Tachypnea, dyspnea, orthopnea
• Cardiomegaly, increased HR
• GI upset, nausea, abdominal pain
• Decreased peripheral pulses
• Hypoxia

Question 7

Treatment of CHF

Answer 7

-Cardiotonic (inotropic) drugs: cardiac glycosides, phosphodiesterase inhibitors, HCN blockers

Question 8

Considerations for children

Answer 8

• Digoxin used for heart defects and related cardiac problems
• Dosage should be double checked
• Monitor closely for digitalis toxicity
• Phosphodiesterase inhibitors and HCN blockers are NOT recommended

Question 9

Considerations for adults

Answer 9

• Instruct to take own pulse
• Daily weights
• Avoid switching between brands of digoxin
• Avoid in pregnancy and lactation

Question 10

Considerations for older adults

Answer 10

• More susceptible to digitalis toxicity
• Adjust dose for renal impairment
• Instruct to take own pulse