Chapter 24

Question 1

Heart failure

Answer 1

Inability of ventricles to pump enough blood for body’s needs
Weakening of heart muscle due to aging or disease

Question 2

Diastolic HF

Answer 2

Dry HF

Stiff ventricles

Question 3

Systolic HF

Answer 3

“floppy” heart

comes with congestion

Question 4

Causes of HF

Answer 4

Coronary artery disease (CAD)
Mitral stenosis
MI
Chronic HTN
Diabetes Mellitus

Question 5

Heart failure S/S

Answer 5

SOB
swelling of legs and feet
chronic low energy
increased nocturia
confusion
swollen tender abdomen
cough w/ frothy sputum

Question 6

Drugs for Heart Failure

Answer 6

ACE Inhibitors (mandatory)
Diuretics (sometimes)
Beta-adrenergic blockers (mandatory)
Vasodilators (sometimes)
Cardiac glycosides (sometimes)
Phosphodiesterase inhibitors

must be on asprin and plavix

Question 7

ACE inhibitor considerations

Answer 7

African Americans ↑ risk for angioedema, can be fatal

Monitor Na+

Question 8

Diuretics action

Answer 8

Decrease BP by inhibiting sodium & water retention by kidneys
Cause loss of electrolytes

Question 9

Beta–Adrenergic Blockers action

Answer 9

HF tx
decrease heart rate and contractility
↓ conduction velocity through AV node

Question 10

Beta–Adrenergic Blockers indications

Answer 10

First-line drug for hypertension

Angina, Dysrhythmias, Heart failure, Myocardial infarction

Question 11

Beta–Adrenergic Blockers considerations

Answer 11

Poor response with African-American clients
Non-compliance-impotence & ↓ libido
Do not use in PT’s with lung problems

Question 12

Vasodilators action

Answer 12

relaxes smooth muscles of blood vessels
drops BP & increases water & sodium retention
minor role in HF tx

Question 13

Vasodilators side effects

Answer 13

reflex tachycardia
sodium & water retention (listen to lungs)
dizziness
palpitations
CVA
BP < 90/60
priaprism (erection)

Question 14

Cardiac Glycosides action

Answer 14

Increase force of heartbeat

slow heart rate

Question 15

Cardiac Glycosides considerations

Answer 15

Narrow therapeutic range 0.8-2.0 ng/ml
Hypokalemia potentiates digoxin toxicity
Antibiotic + digoxin can precipitate toxicity

Question 16

Cardiac Glycosides toxicity S/S

Answer 16

mild: “flu-like” symptoms (N & V),
severe: visual disturbances (blurred, green or yellow vision or halo effect)

Question 17

Cardiac Glycosides antidote

Answer 17

digibind for extreme toxicity

lasts several days in the body

Question 18

Phosphodiesterase Inhibitors primary use

Answer 18

as short-term therapy for heart failure

given IV

Question 19

Phosphodiesterase Inhibitors adverse effects

Answer 19

hypokalemia, hypotension, ventricular dysrhythmias

Question 20

Phosphodiesterase Inhibitors considerations`

Answer 20

check K+ levels

check VS q 15 min

Question 21

ACE ending

Answer 21

pril