Agents for Treating HF Flashcards
What is afterload?
The resistance that the heart has to work against to open the mitral valve and push blood into the system.
AKA systemic or peripheral vascular resistance
What is cardiac output, how do we calculate it, and what is the normal CO for a healthy adult?
the amount of blood the heart pumps through the circulatory system in 1 minute
Normal is 4.7 L/min
SV x HR
What is cardiomegaly and what causes it?
enlargement of the heart muscle
Caused by infection, alcoholism, steroids, chronic HTN, valvular disease, and HF
What is cardiomyopathy and what does it cause?
A disease of the heart muscle
Causes a weakened heart and eventual complete heart failure and death
What is chronotropic agent?
something that can change the heart rate
What is dyspnea and what disease of the heart is it often associated with?
discomfort with respirations, often with a feeling of anxiety and inability to breathe
Left-Sided Heart Failure which makes sense b/c in this causes fluid build up in the lungs
Define Heart Failure
a condition where the heart has a decreased ability to pump enough blood around the body
Leads to blood backup, or congestion, in the system
What is hemoptysis?
blood-tinged sputum seen in left-sided heart failure when blood backs up into the lungs and fluid leaks out into the lung tissue
What is nocturia?
The increased action of getting up to pee at night
The nurse’s patient states, “I’m so tired because I’ve been having to get up to pee so much at night”. This is known as ___________.
nocturia
What conditions are associated with nocturia and how?
increased renal perfusion when the patient is in the supine position d/t gravity-dependent edema r/t to HF
UTI also increases the need to pee
What is orthopnea?
difficulty breathing when lying down
What is a positive inotrope?
a drug/chemical that causes an increase in the force of the muscle contraction of the heart
What is preload?
the amount of blood that is brought back to the heart to be pumped throughout the body
Puts pressure on the ventricles of the heart
What is pulmonary edema?
Loss of fluid into the lung tissue
The is caused by severe left-sided heart failure, which causes fluid backup into the lungs
What is tachypnea?
Rapid and shallow respirations seen with left-sided heart failure
What is the goal when we treat CHF?
Get the heart to contract more efficiently in an effort to bring the cardiovascular system back into back and perfuse the body
What is the leading cause of CHF?
Coronary Artery Disease (CAD)
What is valvular heart disease?
Regurgitation of a valve so blood backs up into the ventricle
The ventricle has to work harder and harder to get it’s 4.7L/min to the body, so the muscle wears out and eventually is damaged
What are the causes of cardiac muscle damage during HF?
Atherosclerosis and cardiomyopathy
When the heart has an increase in workload because it needs to maintain an efficient output of blood, why does it do that?
HTN and/or
Valvular disease
What causes structural abnormalities in the heart?
congenital cardiac defects
What are the compensatory mechanisms for decreased CO and how do they work?
Sympathetic stimulation: increased vasoconstriction leads to increased HR leads to increased CO
Renin Release: leads to fluid retention leads to increased CO leads to increased perfusion
What are the s/sx of left-sided HF?
anxiety
tachypnea dyspnea orthopnea hemoptysis rales
cardomegaly
S3 sounds
increased HR
GI upset: nausea, abdominal pain
Hypoxia: decreased peripheral pulses
What are the s/sx of right-sided HF?
elevated jugular d/t elevated venous pressure
splenomegaly
hepatomegaly
decreased renal perfusion when upright
increased renal perfusion when supine which leads to nocturia
pitting edema
weakness/fatigue
Which 3 classes are positive inotropes?
Cardiac glycosides
Phosphodiesterase inhibitors
HCN Blocker
Why do we use cardiotonic agents with children?
to treat heart defects and related cardiac problems
Which cardiotonic agent is best for children?
Digoxin
What should the nurse monitor for when administering digoxin to a child?
Double check dosage with another nurse
Monitor closely for digitalis toxicity
What education should the nurse provide for adult patients taking a cardiotonic agent (positive inotrope)?
Teach how to take own pulse daily
Daily wts
Do not switch brands of digoxin
Avoid in pg and lactation
What should the nurse monitor for when administering a cardiotonic agent to an older adult?
Digitalis toxicity
Adjust the dose for renal impairment
What education should the nurse provide for an older adult patient taking a cardiotonic agent?
Take your own pulse daily
Daily wts
What drug(s) are cardia glycosides?
Digoxin
Is Digoxin a positive or negative inotrope?
positive
Inamrinone is only for use in patients with _________________________.
HF that has not responses to digoxin, diuretics, or vasodilators
Milrinone is used for …..
the short-term management of HF in patients who are receiving digoxin and diuretics
What does HCN stand for?
Hyperpolarization-Activated Cyclic Nucleotide-Gated
