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Adult Health, Unit 1 > Ch 24 > Flashcards

Ch 24 Flashcards

1
Q

What is cardiomyopathy?

A

A series of progressive events in the cardiac muscle that results in impaired cardiac output; ‘disease of the heart muscle’ classified based on structural and functional abnormalities.

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2
Q

What is dilated cardiomyopathy (DCM)?

A

The most common form of cardiomyopathy characterized by significant dilation and thinning of the ventricles with systolic dysfunction.

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3
Q

What are the characteristics of dilated cardiomyopathy (DCM)?

A

Significant dilation and thinning of the ventricles, no hypertrophy, elevated volumes, and decreased ejection fraction (EF).

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4
Q

What is hypertrophic cardiomyopathy (HCM)?

A

A genetic disorder and leading cause of sudden death in adolescents and young adults, particularly athletes. Heart is thickened from blood not reaching the heart muscle.

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5
Q

What are the characteristics of hypertrophic cardiomyopathy (HCM)?

A

Increased heart muscle size and mass (increased thickness from scarring/fibrosis), especially along the septum, but can involve other areas of the heart. Heart is thickened from blood not reaching the heart muscle.

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6
Q

What is restrictive/constrictive cardiomyopathy (RCM)?

A

The least common type of cardiomyopathy characterized by diastolic dysfunction due to rigid ventricular walls. It becomes stiffened, not thickened.

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7
Q

What causes diastolic dysfunction in restrictive/constrictive cardiomyopathy (RCM)?

A

Rigid ventricular walls that impair diastolic filling and ventricular stretch.

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8
Q

What is unclassified cardiomyopathy?

A

Cardiomyopathy that does not fit into one of the above categories, such as Takotsubo.

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9
Q

What is the major electrolyte involved with cardiomyopathy?

A

Sodium

Sodium plays a critical role in heart function and electrolyte balance. Decreased stroke volume stimulates SNS and RAAS, resulting in increased systemic vascular resistance and increased sodium and fluid retention (from aldosterone)

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10
Q

What condition often leads to heart failure?

A

Cardiomyopathy

Cardiomyopathy refers to diseases of the heart muscle that can affect its size, shape, and thickness.

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11
Q

What develops in part from fluid overload?

A

Heart failure

Fluid overload can increase pressure in the heart and lungs, contributing to heart failure symptoms.

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12
Q

Fluid overload is often associated with elevated _______ intake.

A

sodium

High sodium intake can lead to increased fluid retention in the body.

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13
Q

What is a significant risk factor for hypertrophic cardiomyopathy?

A

Family History

A genetic predisposition is crucial for understanding this condition.

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14
Q

How does older age affect the risk of cardiomyopathy?

A

Increases the risk of structural heart changes

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15
Q

Name three pre-existing conditions that contribute to cardiomyopathy.

A
  • Coronary artery disease (CAD)
  • Hypertension (HTN)
  • Myocardial infarction (MI)
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16
Q

What lifestyle factors are considered modifiable risks for cardiomyopathy?

A
  • Smoking
  • Alcohol use
  • Illicit drug use
  • Obesity
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17
Q

List some other conditions that can increase the risk of cardiomyopathy.

A
  • Diabetes mellitus (DM)
  • Infections
  • Stress
  • Pregnancy
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18
Q

What are the modifiable and non-modifiable risk factors for cardiomyopathy?

A

Modifiable: Smoking, alcohol abuse, illicit drug use, diabetes mellitus, obesity, infections, chronic stress
Non-modifiable: Family history, older age, pre-existing heart conditions

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19
Q

What is the significance of family history in cardiomyopathy?

A

A significant risk factor, particularly for hypertrophic cardiomyopathy, as it is often inherited.

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20
Q

What is pulsus paradoxus?

A

An exaggerated drop (>10 mmHg) in systolic blood pressure during inspiration.

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21
Q

In which conditions is pulsus paradoxus commonly observed?

A
  • Severe cardiomyopathy
  • Pericardial effusion leading to tamponade
  • Other restrictive cardiac conditions
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22
Q

What are common symptoms to document in a medical history assessment for cardiomyopathy?

A
  • Orthopnea
  • Paroxysmal Nocturnal Dyspnea (PND)
  • Chest Pain or Discomfort
  • Fatigue
  • Syncope
  • Swelling (Edema)
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23
Q

What does orthopnea indicate?

A

Difficulty breathing when lying flat, indicating fluid buildup in the lungs due to heart failure.

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24
Q

What are key physical assessment components for cardiomyopathy?

A
  • Weight Changes
  • Blood Pressure Abnormalities
  • Heart Sounds
  • Jugular Venous Distention (JVD)
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25
Q

What does the presence of S3 and S4 gallops indicate?

A

Ventricular dysfunction.

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26
Q

What psychosocial factors should be evaluated in cardiomyopathy patients?

A
  • Mood
  • Coping mechanisms
  • Compliance with care
  • Stress levels
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27
Q

What are some classic symptoms of cardiomyopathy?

A
  • Orthopnea and Dyspnea
  • Fatigue
  • Chest Pain
  • Palpitations
  • Swelling (Peripheral Edema)
  • Syncope
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28
Q

True or False: Fatigue in cardiomyopathy is primarily due to reduced oxygen delivery to tissues.

A

True

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29
Q

What is paroxysmal nocturnal dyspnea (PND)?

A

Sudden nighttime breathlessness, often waking the patient.

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30
Q

What should be documented in the medical history for cardiomyopathy diagnosis?

A

Risk factors and symptoms like orthopnea, fatigue, and PND.

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31
Q

Fill in the blank: Pulsus paradoxus is measured by taking blood pressure during _______ and _______.

A

inspiration and expiration

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32
Q

What does jugular venous distention (JVD) reflect?

A

Elevated central venous pressure, a marker of fluid overload.

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33
Q

What impact can depression or anxiety have on cardiomyopathy patients?

A

It can impact adherence to treatment and worsen outcomes.

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34
Q

What lifestyle factors contribute to the risk of cardiomyopathy?

A
  • Smoking
  • Alcohol abuse
  • Illicit drug use (e.g., cocaine, amphetamines)
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35
Q

What are the consequences of myocardial infarction (MI) in the context of cardiomyopathy?

A

It can lead to scarring and weakened heart muscle.

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36
Q

What is the purpose of anticipating changes in condition in cardiomyopathy?

A

To proactively monitor the progression of cardiomyopathy to prevent complications.

Failure to act early can lead to severe complications like heart failure, arrhythmias, or even sudden cardiac death.

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37
Q

What complications may arise from not intervening in cardiomyopathy?

A
  • Heart Failure
  • Arrhythmias
  • Thromboembolism
  • Sudden Cardiac Death
  • Functional Decline

These complications can severely impact the patient’s health and quality of life.

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38
Q

True or False: Early intervention is critical to minimize the impact of complications in cardiomyopathy.

A

True

Early intervention helps in reducing the severity and impact of complications.

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39
Q

What are the key diagnostic tools for assessing heart function in cardiomyopathy?

A
  • Echocardiogram
  • Cardiac MRI

These diagnostics help determine the severity of the disease and guide treatment planning.

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40
Q

Fill in the blank: The goal of medications for cardiomyopathy is to _______.

A

[improve heart function, reduce symptoms, and prevent progression]

Medications play a crucial role in managing the condition.

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41
Q

What are common medications used in the treatment of cardiomyopathy?

A
  • Beta-Blockers (e.g., Metoprolol, Carvedilol)
  • ACE Inhibitors or ARBs (e.g., Lisinopril, Losartan)
  • Diuretics (e.g., Furosemide)
  • Anticoagulants (e.g., Warfarin)
  • Antiarrhythmics (e.g., Amiodarone)

These medications target various aspects of heart function and symptom management.

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42
Q

What advanced treatments may be considered in the advanced stages of cardiomyopathy?

A
  • Implantable Cardioverter Defibrillators (ICDs)
  • Cardiac Resynchronization Therapy (CRT)
  • Left Ventricular Assist Device (LVAD)
  • Heart Transplant

These interventions aim to support heart function and improve patient outcomes.

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43
Q

What is the goal of collaboration with the healthcare provider in managing cardiomyopathy?

A
  • Promote cardiac output
  • Enable activity tolerance
  • Teach self-care
  • Reduce anxiety
  • Avoid complications

A comprehensive care plan is essential for effective management.

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44
Q

What are the key takeaways regarding the management of cardiomyopathy?

A
  • Anticipating complications
  • Critical thinking for interventions
  • Importance of diagnostics
  • Role of medications and advanced therapies
  • Collaboration with healthcare providers

These elements are crucial for improving patient quality of life and outcomes.

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45
Q

What are common heart failure medications prescribed for cardiomyopathy?

A

Medications like beta-blockers, ACE inhibitors, diuretics, and anticoagulants.

These medications help manage heart function and symptoms.

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46
Q

What is the recommended sodium intake for patients with fluid retention?

A

Less than 2g/day sodium.

A low sodium diet is essential to manage fluid retention.

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47
Q

What is the typical fluid restriction for patients with cardiomyopathy?

A

Typically less than 2L/day.

This helps prevent fluid overload.

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48
Q

What lifestyle changes should be implemented for patients with cardiomyopathy?

A

Balance of exercise and rest to avoid overexertion while maintaining muscle strength.

This helps manage symptoms and improve quality of life.

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49
Q

How should patients with Hypertrophic Cardiomyopathy manage dehydration?

A

Avoid dehydration, as it can worsen symptoms due to reduced preload.

Proper hydration is critical in managing HCM.

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50
Q

What should be the positioning of legs for a patient with fluid overload?

A

Keep legs neutral or slightly down.

Elevating legs may worsen symptoms by increasing preload.

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51
Q

What should patients recognize and report regarding arrhythmias?

A

Lightheadedness, dizziness, orthostatic hypotension, racing heartbeats, diaphoresis, or confusion.

Recognizing these symptoms is crucial for timely intervention.

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52
Q

What activities should patients with cardiomyopathy plan?

A

Alternate rest and activity while avoiding isometric or strenuous exercises.

This helps manage workload on the heart.

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53
Q

What is the weight gain threshold for patients to report to their provider?

A

2–3 lbs (0.9–1.4 kg) in 1 day or 5 lbs (2.3 kg) in 1 week.

Sudden weight gain may indicate fluid retention.

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54
Q

What symptoms indicate worsening fluid overload?

A

Increased swelling in ankles, feet, or abdomen, unusual shortness of breath, persistent cough, or loss of appetite.

These symptoms require immediate medical attention.

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55
Q

What dietary recommendations should patients follow?

A

Avoid tobacco and alcohol, check sodium content in food labels, avoid processed or canned foods, and follow the provider’s written diet plan.

These changes help manage heart failure symptoms.

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56
Q

What community resources should be identified for patients?

A

Support groups for heart failure, assistance with medications or dietary changes, and emotional support.

These resources can aid in lifestyle management and emotional well-being.

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57
Q

True or False: Patients should elevate their legs for fluid overload.

A

False.

Keeping legs down is preferred to avoid increased venous return.

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58
Q

Fill in the blank: Patients should report __________ to their primary provider.

A

symptoms of weight gain, increased swelling, unusual shortness of breath, persistent cough, or profound fatigue.

These are critical indicators of worsening condition.

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59
Q

What is the goal of the evaluation phase in cardiomyopathy care?

A

Determine the effectiveness of the care plan and make adjustments as needed.

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60
Q

What indicators suggest a patient’s condition is improving?

A
  • Decreased shortness of breath
  • Reduced peripheral edema or weight stabilization
  • Improved activity tolerance and energy levels
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61
Q

What are the signs of worsening in a patient with cardiomyopathy?

A
  • Signs of fluid overload (weight gain, increased swelling)
  • Exacerbation of symptoms (fatigue, dyspnea, orthopnea)
  • New onset or worsening of arrhythmias
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62
Q

What areas should be reassessed during the evaluation?

A
  • Physical Assessment
  • Medication Adherence
  • Lifestyle Modifications
  • Psychosocial Support
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63
Q

What should be checked during the physical assessment?

A
  • Ongoing or new symptoms
  • Vital signs
  • Blood pressure
  • Heart rate
64
Q

What should be confirmed regarding medication adherence?

A
  • Patient is taking medications as prescribed
  • Assessment for side effects
  • Reevaluation of medication regimen for effectiveness
65
Q

What lifestyle modifications need confirmation during reassessment?

A
  • Adherence to fluid and sodium restrictions
  • Exercise plans
  • Tobacco/alcohol avoidance
66
Q

What decisions need to be made regarding the care plan?

A
  • Stopped
  • Changed
  • Continued
67
Q

What types of interventions should be stopped in the care plan?

A
  • Discontinue ineffective interventions
  • Medications causing adverse effects without benefit
68
Q

What changes might be made to the care plan?

A
  • Adjust dosages
  • Switch medications
  • Modify dietary plans due to noncompliance
69
Q

What should be continued in the care plan?

A
  • Effective interventions
  • Patient education
  • Monitoring to reinforce compliance
70
Q

What is the goal of the teach-back method?

A

Evaluate the patient’s understanding of their condition and the care plan.

71
Q

What should patients be able to explain in the teach-back method?

A
  • Signs and symptoms to monitor
  • Purpose and proper use of medications
  • Lifestyle changes to maintain
  • Importance of follow-up appointments
72
Q

Why is it important for patients to understand their care plan?

A

Reduces the risk of noncompliance or complications.

73
Q

What does the evaluation phase involve?

A
  • Monitoring condition
  • Reassessing symptoms and adherence
  • Deciding on care plan adjustments
  • Confirming patient understanding
74
Q

What is the purpose of health history assessment in heart failure?

A

To identify risk factors and contributing conditions for heart failure.

75
Q

Which demographics are at higher risk for heart failure?

A
  • Higher prevalence among African Americans and Hispanics compared to Caucasians
  • Men are more affected than women
  • Risk increases with age, particularly in adults over 60 years old
76
Q

What medical conditions contribute to heart failure risk?

A
  • Coronary artery disease (CAD)
  • Myocardial infarction (MI)
  • Sustained hypertension
  • Valvular disease
  • Cardiomyopathy
  • Metabolic syndrome
  • Kidney failure
  • Obstructive sleep apnea (OSA)
77
Q

How does lifestyle affect heart failure risk?

A
  • Smoking
  • Obesity
  • Sedentary lifestyle
78
Q

What symptoms should be asked about regarding heart failure?

A
  • Congestion
  • Fatigue
  • Dyspnea
  • Fluid retention
79
Q

Fill in the blank: Symptoms of congestion include _______.

A

[Sleep disturbances, fatigue, dyspnea with exertion or at rest, edema, weight gain]

80
Q

What are key signs of poor perfusion to assess in heart failure?

A
  • Jugular venous distention (JVD)
  • Gallop rhythms (S3 and S4)
  • Cool extremities or pallor
  • Resting tachycardia
  • Confusion
81
Q

What cardiovascular assessments indicate fluid overload in heart failure?

A
  • Jugular venous distention (JVD)
  • Gallop rhythms like S3 and S4
  • Murmurs indicating valvular diseases
82
Q

What respiratory signs indicate fluid buildup in heart failure?

A
  • Persistent pulmonary crackles
  • Dyspnea
  • Orthopnea
  • Labored breathing at rest
83
Q

What abdominal and peripheral assessments should be conducted in heart failure?

A
  • Hepatomegaly
  • Ascites
  • Dependent edema
  • Rapid weight gain
84
Q

What psychosocial factors should be assessed in heart failure patients?

A
  • Anxiety
  • Restlessness
  • Family and community support systems
85
Q

What diagnostic tests are used in heart failure assessment?

A
  • Echocardiogram
  • Chest X-Ray (CXR)
  • Electrocardiogram (ECG)
  • Laboratory tests (BNP, CMP, CBC, UA)
86
Q

What does a B-Type Natriuretic Peptide (BNP) level >100 pg/mL suggest?

A

Heart failure

87
Q

What are the cardinal manifestations of heart failure related to congestion?

A
  • Dyspnea
  • Orthopnea
  • Paroxysmal nocturnal dyspnea (PND)
  • Cough
  • Pulmonary crackles
  • Edema
  • Abdominal bloating
  • Rapid weight gain
88
Q

What are the signs of poor perfusion/low cardiac output in heart failure?

A
  • Fatigue
  • Exercise intolerance
  • Cool extremities or pallor
  • Resting tachycardia
  • Confusion or altered mental state
  • Daytime oliguria
89
Q

True or False: Fatigue in heart failure can indicate an inability to tolerate physical activity.

90
Q

What key questions should nurses ask regarding blood flow in heart failure?

A
  • Where is blood backing up (congestion)?
  • Where is blood not flowing adequately (perfusion)?
91
Q

What is the definition of pulmonary edema?

A

Pulmonary edema is a severe and sudden exacerbation of heart failure where fluid rapidly accumulates in the lungs, leading to impaired gas exchange and respiratory distress.

Pulmonary edema can occur in acute decompensated heart failure and requires immediate medical attention.

92
Q

List the respiratory symptoms associated with pulmonary edema.

A
  • Decreased oxygen saturation
  • Severe shortness of breath (dyspnea), especially when lying flat
  • Coughing with frothy sputum, which may be tinged with blood
93
Q

What skin changes may indicate pulmonary edema?

A
  • Cyanotic skin (bluish discoloration)
  • Cool and clammy extremities
94
Q

What neurological signs can be observed in a patient with pulmonary edema?

A
  • Restlessness
  • Confusion
  • Anxiety
95
Q

What cardiac findings are associated with pulmonary edema?

A
  • Tachycardia (rapid heart rate)
  • Jugular venous distention (JVD) from fluid overload
96
Q

What is required for the treatment of pulmonary edema?

A

Emergency action and hospitalization are required for immediate interventions to relieve symptoms and prevent further deterioration.

This includes therapies like oxygen delivery, diuretics, vasodilators, and inotropes.

97
Q

How does oxygen delivery help in the treatment of pulmonary edema?

A

Oxygen delivery improves oxygenation and reduces hypoxemia.

98
Q

What role do diuretics play in the management of pulmonary edema?

A

Diuretics, administered intravenously (e.g., furosemide), reduce fluid overload and pulmonary congestion.

99
Q

What is the function of vasodilators in treating pulmonary edema?

A

Vasodilators like IV Nitroglycerin (NTG) reduce preload and afterload, improving cardiac output and reducing pulmonary congestion.

100
Q

Which medications are classified as inotropes in the context of pulmonary edema treatment?

A
  • Milrinone
  • Dobutamine
  • Dopamine
101
Q

What positioning is recommended for a patient with pulmonary edema?

A

High Fowler’s position (sitting upright) to decrease preload and improve lung expansion.

102
Q

What are the potential consequences of acute decompensation in heart failure?

A
  • Cardiogenic Shock
  • Thromboembolism
  • Pericardial Effusion or Tamponade
  • Cardiac Arrest
103
Q

What are key nursing interventions for pulmonary edema?

A
  • Administer oxygen to relieve hypoxemia
  • Position the patient upright
  • Administer IV diuretics
  • Monitor for worsening respiratory distress
  • Provide reassurance
104
Q

True or False: Pulmonary edema is a medical emergency requiring rapid intervention.

105
Q

What is the primary focus of treatment for pulmonary edema?

A

Relieving fluid overload, improving oxygenation, and stabilizing cardiac function.

106
Q

What is heart failure (HF)?

A

A chronic, progressive condition where the heart’s ability to pump or fill with blood is impaired

Can involve the left ventricle, right ventricle, or both, leading to pulmonary or systemic congestion.

107
Q

What is the primary problem in Left-Sided Heart Failure?

A

The left ventricle fails to pump blood effectively into the systemic circulation.

108
Q

What are the two types of dysfunction associated with Left-Sided Heart Failure?

A
  • Systolic dysfunction (impaired contraction)
  • Diastolic dysfunction (impaired filling)
109
Q

What is a key feature of Left-Sided Heart Failure?

A

Pulmonary Congestion

110
Q

What symptom is characterized by shortness of breath, especially on exertion or lying flat?

111
Q

What type of cough is associated with Left-Sided Heart Failure?

A

Persistent cough, often accompanied by frothy sputum

112
Q

What heart sounds may be heard in Left-Sided Heart Failure?

A
  • S3 gallop (early diastole, indicating volume overload)
  • S4 (late diastole, from stiff ventricles)
113
Q

What is a major complication of Left-Sided Heart Failure?

A

Pulmonary edema

114
Q

What is the primary problem in Right-Sided Heart Failure?

A

The right ventricle fails to pump blood effectively into the pulmonary circulation.

115
Q

What condition often leads to Right-Sided Heart Failure?

A

Left-sided heart failure

116
Q

What is a key feature of Right-Sided Heart Failure?

A

Systemic Congestion

117
Q

What symptom is caused by elevated venous pressure in Right-Sided Heart Failure?

A

Jugular Venous Distention (JVD)

118
Q

What are common symptoms of Right-Sided Heart Failure?

A
  • Peripheral Edema
  • Weight Gain
  • Hepatomegaly
  • Ascites
119
Q

Which chronic lung disease can lead to isolated right-sided failure?

A

Pulmonary hypertension

120
Q

What is congestive heart failure (CHF)?

A

When both left and right sides of the heart fail together.

121
Q

What are the combined symptoms of CHF?

A

Combined symptoms of pulmonary and systemic congestion.

122
Q

What is essential for the management of heart failure?

A

A combination of lifestyle changes and medications.

123
Q

What are the consequences of acute episodes of heart failure?

A
  • Increased hospitalizations
  • Higher healthcare costs
  • Decreased quality of life
124
Q

What is primarily affected by Left-Sided Heart Failure?

A

The lungs, causing pulmonary symptoms.

125
Q

What is a major focus of effective management of heart failure?

A
  • Medication adherence
  • Lifestyle changes
  • Regular monitoring
126
Q

What is the role of nurses in the treatment of heart failure?

A

Implementing and coordinating the treatment plan

This involves administering medications, monitoring patient condition, and providing education.

127
Q

What medications are commonly administered for heart failure?

A

Diuretics, beta-blockers, ACE inhibitors, ARBs

Nurses should monitor for side effects and adjust doses as needed.

128
Q

How can nurses promote activity tolerance in heart failure patients?

A

Encourage gradual increases in physical activity starting with limited or supervised activities

129
Q

What is the purpose of using diuretics in heart failure management?

A

Prevent fluid retention and monitor fluid intake/output closely

130
Q

What dietary restrictions should be monitored for heart failure patients?

A

Sodium and fluid restrictions

131
Q

What lab results should nurses monitor in heart failure patients?

A

Potassium, BNP, renal function

Frequent monitoring of vital signs is also necessary.

132
Q

How should a patient with left-sided heart failure be positioned?

A

Elevate the head of the bed to facilitate breathing and reduce pulmonary congestion

133
Q

What position should be recommended for a patient with right-sided heart failure?

A

Elevate the feet to reduce dependent edema. Only if they do not also have left sided heart failure because pulmonary congestion takes priority.

134
Q

What emotional support strategies should nurses provide to heart failure patients?

A

Provide emotional support and coping mechanisms for stress and lifestyle changes

135
Q

Why is patient education important in heart failure management?

A

Empowers patients to manage their condition and recognize early signs of worsening heart failure

136
Q

What should patients be educated about regarding their medications?

A

Purpose, possible side effects, and importance of compliance

137
Q

What weight changes should patients report to their provider?

A

Weight gain of 2–3 lbs in 1 day or 5 lbs in 1 week

138
Q

What dietary modifications should heart failure patients follow?

A

Low-sodium and fluid-restricted diets

Nutritional guidance may include iron supplementation and omega-3 fatty acids.

139
Q

What lifestyle modifications are encouraged for heart failure patients?

A

Smoking cessation, limiting alcohol intake, stress reduction

140
Q

What symptoms of worsening heart failure should patients recognize?

A

Fluid overload signs such as dyspnea, edema, fatigue

141
Q

What is orthopnea?

A

Difficulty breathing while lying down, improved by using multiple pillows or sleeping in a reclined position

142
Q

What is Paroxysmal Nocturnal Dyspnea (PND)?

A

Sudden nighttime dyspnea due to fluid redistributing into the lungs when lying down

143
Q

What are the key goals in managing heart failure?

A

Promote activity tolerance, manage fluid volume, provide comprehensive support

144
Q

True or False: Nursing interventions for heart failure focus solely on medication management.

A

False

Interventions also include education, lifestyle changes, and emotional support.

145
Q

Fill in the blank: Nursing interventions aim to improve outcomes and reduce _______ for patients with chronic heart failure.

A

hospitalizations

146
Q

What symptoms need to be reassessed in heart failure evaluation?

A

Signs of improvement or worsening of heart failure symptoms:
* Dyspnea
* Fatigue
* Peripheral edema or weight changes
* Orthopnea
* Paroxysmal nocturnal dyspnea
* New or worsening pulmonary congestion

This includes evaluating dyspnea especially with activity or at rest, and monitoring for new or worsening pulmonary congestion, such as crackles or coughing.

147
Q

What laboratory results should be monitored during heart failure evaluation?

A

Laboratory results to monitor include:
* Electrolytes
* Kidney function (creatinine and BUN)
* B-Type Natriuretic Peptide (BNP)

It is crucial to ensure diuretic therapy is not causing imbalances and to assess fluid status and overall heart failure severity.

148
Q

What interventions should be stopped in the heart failure plan of care?

A

Interventions to be stopped:
* Discontinue ineffective or harmful interventions

This includes medications that result in significant side effects or electrolyte imbalances.

149
Q

What changes might be made to the heart failure treatment plan?

A

Changes to consider:
* Adjust medication dosages
* Modify fluid restrictions
* Change activity levels

These adjustments should be based on the patient’s response and tolerance.

150
Q

What elements should be continued in the heart failure care plan?

A

Elements to be continued:
* Reinforce effective interventions
* Encourage adherence to weight monitoring
* Promote a low-sodium diet
* Schedule follow-up appointments

Effective interventions may include medications and dietary adjustments.

151
Q

How can one determine if the patient’s condition is improving, resolved, or worsening?

A

Indicators of condition status:
* Improving: Reduced symptoms, stable lab results
* Worsening: Signs of fluid overload, decreased exercise tolerance, new complications

Transition to palliative care may be discussed if the condition continues to deteriorate despite treatment.

152
Q

What is the purpose of the ‘teach back’ method in patient education?

A

The purpose is to ensure the patient understands:
* Their condition
* The care plan
* Necessary lifestyle changes

This includes their ability to explain medication purposes, fluid and sodium restrictions, and when to report worsening symptoms.

153
Q

What key topics should patients be able to explain in a teach-back session?

A

Key topics include:
* Medication purposes and side effects
* Fluid and sodium restrictions
* Reporting worsening symptoms
* Weight monitoring and activity recommendations

Examples of worsening symptoms include weight gain of 2–3 lbs in 1 day or 5 lbs in 1 week.

154
Q

What emotional health considerations should be assessed in heart failure patients?

A

Considerations include:
* Patient’s anxiety levels
* Emotional stress signs

Providing support as needed is crucial for managing emotional health.

155
Q

How can activity levels be assessed in heart failure patients?

A

Assessment of activity levels includes:
* Ability to perform ADLs with less fatigue
* Addressing physical limitations in the care plan

This involves evaluating whether the patient can perform daily activities with less shortness of breath.

156
Q

True or False: Heart failure evaluation focuses solely on laboratory results.

A

False

Heart failure evaluation also focuses on monitoring symptoms and the effectiveness of interventions.

Adult Health, Unit 1 (2 decks)

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