Ch 47

Question 0

What are 5 early symptoms of CHF

Answer 0

Fatigue
Shortness of breath 
Venous distention 
Peripheral edema 
Pulmonary edema

Question 1

What are 4 complications of CHF

Answer 1

Ventricular dysfunction
Reduced cardiac output
Insufficient tissue perfusion
Fluid retention

Question 2

There are 4 classes of heart failure and they are

Answer 2

Class I: no limitation of ordinary physical activity
Class II: slight limitation of physical activity, normal activity producers fatigue, dyspnea, palpitations or angina
Class III: marked limitation of physical activity, produces symptoms
Class IV: symptoms occur at rest

Question 3

To achieve therapeutic goals in heart failure what 3 actions should take place

Answer 3

Treat correctable underlying causes
Implement non drug measures
Drug therapy if no response from first two

Question 4

What are 6 non drug measures to treat heart failure

Answer 4

Limit salt intake to 2 mg a day 
Reduce caloric diet 
Bed rest 
Regular mild exercise 
Avoid alcohol 
Avoid excessive fluids

Question 5

Beta blockers must be used with CAREFUL CONTROL… What are 3 things they can help improve

Answer 5

Left ventricular ejection
Exercise tolerance
Slow progression of heart failure

Question 6

Spironolactone (aldosterone receptor blocker) can reduce symptoms, decrease hospitalizations, prolong life in patients with what

Answer 6

Moderate to severe heart failure

Question 7

Aldosterone promotes 4 things and activates what

Answer 7

Myocardial remodeling 
Myocardial fibrosis
Vascular fibrosis 
Baroreceptors dysfunction 
Activates sympathetic nervous system and suppresses NE uptake in heart

Question 8

Myocardial remodeling does what

Answer 8

Impairs pumping of heart

Question 9

Myocardial fibrosis does what

Answer 9

Increases risk of dysrhythmias

Question 10

Vascular fibrosis does what

Answer 10

Decreases arterial elasticity and increases hypertension

Question 11

Ionotropic agents have what 2 benefits

Answer 11

Increase force of myocardial contraction

Improve performance of failing heart

Question 12

What are 3 types of ionotropic agents

Answer 12

Cardiac glycosides
Sympathomimetics
Phosphodiesterase inhibitors

Question 13

What is the medication used for as an example for cardiac glycosides

Answer 13

Digoxin

Question 14

What are the two drugs that are on the Sympathomimetics class

Answer 14

Dopamine

Dobutamine

Question 15

What drug falls under phosphodiesterase inhibitor class

Answer 15

Inamrinone

Question 16

Digoxin is a naturally occurring compound and affects what properties of the heart

Answer 16

Mechanical and electrical

Question 17

Digoxin has a high incidence of toxicity and has positive inotropic action which means what

Answer 17

Increases force of ventricular contraction and increases CO

Question 18

Digoxin inhibits what two things

Answer 18

Sodium

Potassium atpase

Question 19

Digoxin by inhibition causes calcium to accumulate in heart muscle which causes what

Answer 19

Increased contractile force of the myocardium

Question 20

All patients with heart failure should take what (and if edema is present should take with a diuretic too)

Answer 20

Ace inhibitor

Question 21

Aspirin and NSAIDS decrease effects of what drugs

Answer 21

Diuretics

Question 22

All patients with class II or III should take this class of drugs (along with ace inhibitor and diuretic)

Answer 22

Beta blockers

Question 23

This drug can be used in combination with diuretics, ace inhibitors, and beta blockers

Answer 23

Digoxin

Question 24

This drug has shown to prolong life and should be given to all patients with heart failure

Answer 24

Spironolactone