Chapter 26 Flashcards
_____ ____ is the acute inability of the heart to pump enough blood to meet the body’s oxygen and nutrient needs
Pulmonary edema (acute heart failure)
___ _____ occurs when the right side of the heart fails because of an increased workload caused by pulmonary disease
Cor pulmonale
Organ enlargement that may occur with right-sided heart failure is known as _____ and ______
splenomegaly and hepatomegaly
The goal of treatment for heart failure is to improve the heart’s pumping ability and decrease the heart’s workload by reducing ______ ______ ______
peripheral vascular resistance
______ ______ ______ causes supine patients to awake suddenly with a feeling of suffocation
Paroxysmal nocturnal dyspnea
The end-diastole stretch in the ventricles produced by the ventricular volume is _____
preload
The tension in the ventricular wall during systole necessary to overcome vascular resistance is _____
afterload
______ is dyspnea that occurs when the patient lies down
Orthopnea
Chose right or left sided heart failure \_\_\_ Dry cough \_\_\_ Peripheral edema \_\_\_ Crackles \_\_\_ Hepatomegaly \_\_\_ Jugular venous distention \_\_\_ Dyspnea \_\_\_ Splenomegaly \_\_\_ Orthopnea
L - Dry cough R - Peripheral edema L - Crackles R - Hepatomegaly R - Jugular venous distention L - Dyspnea R - Splenomegaly L - Orthopnea
A patient is being given digoxin (Lanoxin) to treat heart failure. Which of the following is a usual adult daily dosage of digoxin (Lanoxin?)
a) 0.005 mg
b) 0.025 mg
c) 0.25 mg
d) 2.5 mg
c) 0.25 mg
When the nurse is reviewing a patient’s daily laboratory test results, which of the following electrolyte imbalances should the nurse recognize as predisposing the patient to digoxin toxicity?
a) Hypokalemia
b) Hyperkalemia
c) Hyponatremia
d) Hypernatremia
a) Hypokalemia
If a patient has an elevated pulmonary vascular pressures, the nurse understands that the patient is most likely to develop which of the following physiological cardiac changes?
a) Left atrial atrophy
b) Right atrial atrophy
c) Left ventricular hypertrophy
d) Right ventricular hypertrophy
d) Right ventricular hypertrophy
A patient is admitted to a medical unit with a diagnosis of heart failure. The patient reports increasing fatigue during the past two weeks. Which of the following is the most likely cause of this fatigue?
a) Dyspnea
b) Decreased cardiac output
c) Dry cough
d) Orthopnea
b) Decreased cardiac output
A patient asks the nurse what a diagnosis of heart failure means. Which of the following is the nurse’s best response?
a) Your heart briefly stops
b) Your heart has an area of muscle that is dead
c) Your heart is pumping too much blood
d) Your heart is not an efficient pump
d) Your heart is not an efficient pump
A patient’s chest x-ray examination indicates fluid in both lung bases. Which of the following signs or symptoms present during the nurse’s data collection most reflects these x-ray examination findings?
a) Fatigue
b) Peripheral edema
c) Bilateral crackles
d) Jugular venous distention
c) Bilateral crackles
To monitor the severity of a patient’s heart failure, which of the following data is the most appropriate for the nurse to gather daily?
a) Weight
b) Calorie count
c) Appetite
d) Abdominal girth
a) Weight
Which of the following signs indicates to the nurse that digoxin (Lanoxin) has been effective for a patient?
a) Urine output decreases
b) Urine output increases
c) Heart rate higher than 95 beats per minute
d) Heart rate lower than 50 beats per minute
b) Urine output increases
For a patient who is being discharged on digoxin, the nurse should include which of the following in an explanation to the patient on the signs and symptoms of digoxin toxicity?
a) Poor appetite
b) Constipation
c) Halos around lights
d) Tachycardia
a) Poor appetite
The patient is being discharged on furosemide (Lasix). The nurse evaluates the patient as understanding medication teaching if the patient states that which of the following laboratory tests will be monitored as ordered?
a) I will have my urine sodium checked
b) I will have my calcium level checked
c) I will have my prothrombin time checked
d) I will have my potassium level checked
d) I will have my potassium level checked
Which of the following does the nurse understand are the reasons a patient with pulmonary edema is given morphine sulfate? (Select all that apply)
a) To reduce anxiety
b) To relieve chest pain
c) To strengthen heart contractions
d) To increase blood pressure
e) To reduce preload and afterload
f) To induce amnesia
a) To reduce anxiety
e) To reduce preload and afterload
The nurse evaluates that bumetanide (Bumex) IV is effective in treating pulmonary edema if which of the following patient sins or symptoms is resolved?
a) Pedal edema
b) Jugular venous distention
c) Pink, frothy sputum
d) Bradycardia
c) Pink, frothy sputum
A patient is being taught the action of digoxin, which is an inotropic agent. The nurse defines an inotropic agent as a medication that has which of the following actions?
a) Decreases heart rate
b) Increases heart rate
c) Increases conduction time
d) Strengthens heart contractions
d) Strengthens heart contractions
For a person receiving furosemide (Lasix), the nurse evaluates the medication as being effective if which of the following effects occurs?
a) Bilateral crackles diminish
b) Serum potassium decreases
c) Heart rate increases
d) Pulse pressure increases
a) Bilateral crackles diminish
When caring for an anxious patient with dyspnea, which of the following nursing actions is most helpful to include in the plan of care to relieve anxiety?
a) Increase activity levels
b) Stay at patient’s bedside
c) Pull the privacy curtain
d) Close the patient’s door
b) Stay at patient’s bedside
______ ____ _____ is an older term for heart failure
Congestive heart failure
______ _____ is a clinical syndrome that occurs as a result of the inability of the ventricle(s) to fill or pump enough blood to meet the body’s oxygen and nutrient needs. It may cause dyspnea, fatigue and fluid volume overload in the intravascular and interstitial spaces, resulting in reduced quality and length of life.
Heart failure (HF)
Causes of heart failure are varied and may include:
coronary artery disease (most often) myocardial infarction cardiomyopathy heart valve problems hypertension
In the elderly, the most common cause of heart failure is _____ _____
cardiac ischemia
According to the AHA, _____ million people have heart failure with more than ________ new cases each year
5.7; 670,000
A certain amount of force must be generated by the left ventricle during a contraction to eject blood into the aorta through the aortic valve. This force is referred to as _____
afterload
The pressure within the aorta and arteries influence the force needed to open the aortic valve to pump blood into the aorta. This pressure is called ____ _____ _____
peripheral vascular resistance (PVR)
______ is one of the major causes of left sided heart failure because it increases the pressure within arteries
Hypertension
The major cause of right-sided heart failure is ______
left-sided heart failure
When the right ventricle hypertrophies or fails because of increased pulmonary pressures, it is referred to as __ _____
cor pulmonale
When the _____ _____ fails, it does not empty normally and there is a backward buildup of blood in the systemic blood vessels
right ventricle
As the failure progresses, blood pools into the hepatic veins and the liver becomes congested known as _______. Pain in the right upper quadrant of the abdomen and impaired liver function are caused by this liver congestion
hepatomegaly
Systemic venous congestion also leads to engorgement of the spleen, known as ______
splenomegaly
Any signs and symptoms not related to the lungs are caused by ______
right-sided heart failure
Left-sided heart failure signs and symptoms are found I the _____
lungs
_______ ________ help ensure that an adequate amount of blood is being pumped out of the heart
Compensatory mechanisms
When the sympathetic nervous system detects low cardiac output, it speeds up the heart rate by releasing _______ and _______
epinephrine and norepinephrine
Enlarging the chambers in the heart
dilation
Increasing the muscle mass in the heart
hypertrophy
In dilation, the heart muscle fibers stretch to increase the force of myocardial contractions, which is known as the ____-_____ phenomenon
Frank-Starling
_____ _____, also known as acute heart failure, is sudden severe fluid congestion in the alveoli of the lungs and is life-threatening
Pulmonary edema
_____ _____ occurs with an acute event as an MI or when the heart is severely stressed, causing the left ventricle to fail
Pulmonary edema
