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Pathophysiology Exam 2 > Chapter 20- ❤️ Failure & Circulatory Shock > Flashcards

Chapter 20- ❤️ Failure & Circulatory Shock Flashcards

1
Q

Functions of the heart

The heart moves __________________ blood from the venous system through the __________ ___________ into the ______________ circulation.

A
  • deoxygenated
  • right heart
  • pulmonary
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2
Q

The heart moves ______________ blood from the pulmonary circulation through the ________ heart into the _______ system.

A
  • oxygenated
  • left heart
  • arterial
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3
Q

Preload?

A

Amount of blood coming back to the heart

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4
Q

Afterload?

A

Amount of blood going out of each ventricle

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5
Q

Acute heart failure develops __________?

A

Rapidly

*immediately life threatening

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6
Q

Chronic Heart Failure is a condition associated with what?

A

The heart undergoing adaptive responses

  • adaptive responses can make heart failure worse*
  • most common today
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7
Q

Patients with cardiomyopathy ultimately need what?

A

A ❤️ transplant

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8
Q

Frank - Starling mechanism serves to do what?

A

To match the output of both ventricles

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9
Q

Frank - Sterling mechanism operates through what?

A

Increase preload

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10
Q

Frank-Starling mechanism can lead to what?

A

Ventricular wall tension

  • results in
    - increase in myocardial oxygen requirements leading to ischemia of the heart and further damage
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11
Q

Sympathetic reflexes are “_____ or _____”

A

Fight or flight

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12
Q

Sympathetic reflexes do what?

A
  • increase HR

- increase BP

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13
Q

What side of the ❤️ is the aortic valve on?

A

Left side

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14
Q

What side of the ❤️ is the mitral valve on?

A

Left side

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15
Q

Causes of left sided heart failure?

A
  • Acute myocardial infarction
  • Cardiomyopathy
  • Mitral valve regurgitation
  • Aortic valve stenosis and regurgitation

ALL LEFT SIDED
🤯🤯🤯

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16
Q

Signs and symptoms of left sided heart failure?

A
  • SOB
  • Dyspnea (due to fluid in the lungs)
  • Cyanosis
  • Paroxysmal nocturnal Dyspnea
  • Cheyne-stokes
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17
Q

Left sided heart failure affects the _________?

A

Lungs

Left- Lungs

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18
Q

Symptoms of left sided heart failure?

A
  • cough
  • crackles
  • wheezes
  • blood tinged sputum
  • Tachypnea
  • restlessness
  • confusion
  • orthopnea
  • tachycardia
  • exertional Dyspnea
  • fatigue
  • cyanosis
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19
Q

Why does left sided heart failure affect the lungs?

A

Backing up into VENTRICLES
(Ventricles can’t contain)

Flows into ATRIA
(Atria can’t contain)

Backflows into the lungs

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20
Q

What sound does fluid in the lungs produce?

A

Crackles

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21
Q

In patients with CHF

- sleeping flat= \_\_\_\_\_\_\_
- sleeping with multiple pillows/ in recliner = \_\_\_\_\_\_
A

Sleeping flat = Good

Sleeping w/multiple pillows/recliner = Bad

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22
Q

Right sided Heart Failure Signs and Symptoms?

A
  • Fluid retention and edema
  • Fatigue and limited exercise tolerance
  • cachexia and malnutrition
    eat or breathe? —> patients would rather breath!
  • distention of the jugular veins in right sided HF
  • Diaphoresis and tachycardia
23
Q

Increased peripheral venous pressure is seen in what type of CHF?

A

Right sided heart failure

24
Q

Ascites?

A

Fluid in abdomen

25
Q

Ascites is seen in what type of CHF?

A

Right sided heart failure

26
Q

Enlarged liver and spleen is seen in what type of CHF?

A

Right sided CHF

27
Q

Distended jugular veins = _____________ CHF?

A

Right sided

28
Q

Anorexia and complaints of GI distress are seen with what type of CHF?

A

Right sided

29
Q

Swelling in hands and feet is associated with what type of CHF?

A

Right sided

30
Q

Dependent edema is seen in patients with what type of CHF?

A

Right sided CHF

31
Q

Paroxysmal Nocturnal Dyspnea is seen in what type of CHF?

A

Left sided

32
Q

Elevated pulmonary capillary wedge pressure is seen in what type of CHF?

A

Left sided CHF

33
Q

Pulmonary congestion is seen in what type of CHF?

A

Left sided

34
Q

Restlessness, confusion, fatigue are seen in what type of Congestive Heart Failure?

A

Left sided heart failure

35
Q

What is Orthopnea?

A

Difficulty breathing when lying flat

36
Q

Orthopnea, Tachycardia, Exertional Dyspnea, and Cyanosis are evident with what type of Congestive Heart Failure?

A

Left sided heart failure

37
Q

What is the key diagnostic test to detecting fluid volume?

A

BNP ( Brain Natriuretic Peptide)

  • Great confirmation BECAUSE a chest x-ray showing fluid could be a number of different things such a pneumonia
38
Q

What are 2 types of Circulatory shock?

A

Cardiogenic

Hypovolemic

39
Q

Signs and symptoms of Cardiogenic shock?

A

INITIALLY

  • tachycardia
  • tachypnea
  • normal BP

LATE

  • Cyanosis of lips, nail beds and skin
  • Decreased BP
  • Decrease urine output
40
Q

Treatment for Cardiogenic shock?

A
  • Oxygen

- Intra-aortic balloon pump

41
Q

Hypovolemic shock is caused by what?

A

LOW VOLUME!

either blood loss or just fluid loss

42
Q

When do you start to see a decrease in BP and urine output in somebody with Hypovolemic shock?

A

35% to 45% blood loss

43
Q

What is the standard urinary output an hour?

A

30mL an hour

44
Q

What are the early signs and symptoms of Hypovolemic shock?

A
  • Tachycardia
  • Tachypnea
  • Thirst ( using your fluid)
  • Restlessness (due to lack of O2 to the brain)
  • agitation
45
Q

Parasympathetic Nervous System Does What?

A

Slowes everything down

46
Q

What causes Neurogenic Shock?

A

Spinal cord injury above T6

47
Q

What is the order of treatment for someone with Hypovolemic shock?

A
  1. Crystalloids (.9 NS and Lactate Ringers)—> IV FLUIDS
  2. Blood products
  3. Vasopressures (Ex: norepinephrine, epinephrine)
48
Q

What is the most severe systemic allergic reaction?

A

Anaphylactic Shock

49
Q

Signs and symptoms of Anaphylactic shock?

A
  • Rash
  • Urticaria (hives)
  • Dyspnea
  • Life Threatening*
    • Laryngeal edema and circulatory collapse
50
Q

Treatment for Anaphylactic shock (epi pen) should always be given where?

A

In the thigh

most vascularity

51
Q

Sepsis and septic shock signs and symptoms?

A

EARLY

  • Tachypnea
  • Tachycardia

LATE

  • Hypotension
  • Warm and flushed skin
  • Decreased LOC
  • Decreased urinary output
  • Elevated serum lactate level
  • Metabolic acidosis
52
Q

Treatment for Sepsis and Septic shock?

A
  • Antibiotics (ASAP)

- Fluids

53
Q

What does SIRS stand for?

A

Systemic Inflammatory Response

54
Q

Sepsis is defined as?

A

Suspected or proven infection

Pathophysiology Exam 2 (6 decks)

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