CHF- 2 Flashcards
High output failure
Hyperthyroidism
Anemia
Tachy
Fever
Causes of CHF
HTN
MI
Valve disease
Inflammation/infection
Normal EF
50-70%
Left sided HF
HTN
CAD
Valvular disease
Systolic HF
Thin
Sloppy, floppy
Diastolic HF
Big heart
Normal EF
Can’t handle extra fluid!!!!!
S&S of left heart failure
Paroxysmal nocturnal dyspnea Increase PAWP Blood tinged sputum Confusion Orthopenea Tachy Fatigue Cyanosis
Ask—- left HF
How many pillows Walk far? Wake up SOB Pee at night? No pee during the day? Coughing? Change in ADLs
Left HF objective findings
S3 gallop Displaced PMI to 6th or 7th IC Frothy sputum Tachy Dysthymia Confusion
Flash pulmonary edema
What to do!
High fowlers
Morphine/diuretic/ vasodilators
Oxygen
Digoxin/ doubuamine
Ace ending
Pril
ARB ending
Sartan
Ace and arbs
Reduce afterload
Monitor for this when taking ace or ARB
Hyperkalemia in those with renal failure
BNP
Acute HF Gets rid of sodium Increase kidney profusion Lowers PAWP Separate line- not compatable
1 kg of weight
1 liter of fluid
Digoxin
Increase contractility
Reduce HR
Slow conduction from AV node
Inhibit sympathetic
Milrinone
Vasodilator
Inotropic
Acute HF
Digoxin toxic
Increased with hypokalemia Brady, no p wave, PVCs Vision Appetite Van go
CPAP
Improves CO
EF
Decreased preload and after load, BP and dysthymia
Partial left ventriculectomy
Take out part of LV
Acorn cardiac support device
Mesh jacket
Myosplint
Splint on ventricular for shape and support
Electrical tension
Start ambulation on
Day 2 Increase in 20 bpm Increase in 20 systolic Too stressful Test distance can walk in 6 minutes, then build up
Pulmonary edema
Increased pressure causes fluid to leak from capillaries into lung airways
Pulmonary edema symptoms
Crackles
Dyspnea at rest
