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Adult/Gero I > CHF > Flashcards

CHF Flashcards

1
Q

What is the definition of congestive heart failure?

A

Inability of the myocardium to pump sufficient blood to the tissues of the body to meet metabolic demands

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2
Q

What does aldosterone do?

A

Tells the kidneys to retain sodium and water

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3
Q

What happens when there is a drop in BP?

A

Compensatory vasoconstriction and reflex tachycardia

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4
Q

What is dangerous about having an enlarged heart?

A

Lung can’t fully expand/pressure is being put on the lungs from the heart

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5
Q

How much does 1L of fluid weigh?

A

1 kg/2.2 lb

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6
Q

What is the etiology of CHF?

A

Anything that induces chronic increased volume/pressure/metabolic demand on myocardium
Ex: HTN, Coronary heart disease, Idiopathic cardiomyopathy, Valvular heart disease, Thyrotoxicosis, anemia, hypoxia

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7
Q

What is idiopathic cardiomyopathy?

A

Enlargement of the heart with no known cause

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8
Q

What is cardio output?

A

Volume of blood in liters pumped by the heart in 1 min

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9
Q

What is cardiac index?

A

CO adjusted for BSA

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10
Q

Where does the afterload of the LV comes from?

A

The aorta

Constricted aorta -> high afterload

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11
Q

Where does the afterload of the RV come from?

A

The pulmonary artery

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12
Q

Where does central venous pressure come from?

A

RA

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13
Q

What is a normal CVP (preload RV)?

A

2-8 mmHg

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14
Q

What is a normal PAWP (preload LV)?

A

6-12 mmHg

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15
Q

What is a normal SVR (afterload LV)?

A

800-1200 dynes/sec/cm

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16
Q

What is a normal PVR (afterload RV)?

A

<250 dynes/sec/cm

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17
Q

How should a nurse respond to a high CVP?

A

Taking off fluid because there’s overload

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18
Q

How should a nurse response to a low CVP?

A

Isotonic solution

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19
Q

What is PAWP?

A

Pulmonary artery wedge pressure
Camera inserted with a deflated balloon
Pressure measured when you insert a pulmonary catheter with a balloon into the pulmonary artery
Looking at workload of the left side of the heart

20
Q

What is SVR?

A

Systemic vascular resistance

Afterload of LV

21
Q

What could a high SVR indicate?

A

Stenosis or vasoconstriction pressent

22
Q

What could a low afterload/SVR indicate?

A

Vasodilation

23
Q

What is PVR?

A

Pulmonary vascular resistance

Afterload of RV

24
Q

In a normal heart, ___ and ___ are reflective of each other

A

CVP/PAWP

25
Q

What is cardiac output?

A

HR x SV

26
Q

What can lead to increased preload?

A

Aortic regurgitation

Ventricular septal defect

27
Q

What can lead to increased afterload?

A

(Leftover volume)
Aortic stenosis
HTN

28
Q

What can lead to decreased contractility?

A

MI

Cardiomyopathy

29
Q

What can cause systolic HF?

A 
Impaired contraction (MI)
Increased afterload (HTN)
Mechanical abnormality (valve disease)
30
Q

What is a hallmark sign of systolic HF?

A

Decreased LV EF

31
Q

What is the EF in systolic HF?

A

<45%

32
Q

Who is more commonly affected in systolic HF?

A

Men>women

33
Q

What can cause diastolic HF?

A 
Stuff ventricles, leading to high filling pressure
LVH secondary to HTN
Myocardial ischemia
Valve disease
Cardiomyopathy
34
Q

What are 2 hallmark signs of diastolic HF?

A

Decreased stroke volume and CO

HF with normal EF

35
Q

Who is more commonly affected in diastolic HF?

A

Women>men

36
Q

What are 3 compensatory mechanisms for CHF?

A

^ sympathetic adrenergic activity
^ preload secondary to activation of renin-angiotensin-aldosterone system
Ventricular hypertrophy

37
Q

What are symptoms of left-sided heart failure?

A 
Fatigue
Edema
Weight gain
Cough
Dyspnea
Sleeplessness
Angina
Palpitations
38
Q

What are symptoms of right-sided heart failure?

A 
Fatigue
Edema
Dyspnea in extreme late-stage
Sleeplessness
Angina
Palpitations
39
Q

How do you manage HF?

A

Lifestyle mod

Symptom monitoring

40
Q

What are pharmacological treatments for HF?

A 
ACEIs
Diuretics
Beta blockers
Digoxin/Lanoxin
ARBs
Morphine
Anticoagulants
41
Q

What are ACEIs and what do they do?

A

Angiotensin converting enzyme inhibitors
“pril” drugs”
Prevent AGT II from forming -> lower BP

42
Q

What are some examples of diuretics?

A

Thiazides and loops

HCTZ or furosemide/Lasix

43
Q

What are beta blockers?

A

“olol” drugs

44
Q

What are Digoxin/Lanoxin and what do they do?

A

Positive inotrope
Decrease HR, increase contractility to decrease workload and O2 consumption
*Watch for low K+/HR

45
Q

What are ARBs and what do they do?

A

Angiotensin II receptor blockers
“sartan” drugs
Lower BP

46
Q

What will you see in left-sided HF?

A 
Pulmonary edema
SOB
Cough
Sleeping with pillows
Pink, frothy sputum if there’s flash pulmonary edema
47
Q

What will you see in right-sided HF?

A

Peripheral edema
Ascites
JVD

Adult/Gero I (3 decks)

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