CHF

Question 1

What is the definition of congestive heart failure?

Answer 1

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

Question 2

What does aldosterone do?

Answer 2

Tells the kidneys to retain sodium and water

Question 3

What happens when there is a drop in BP?

Answer 3

Compensatory vasoconstriction and reflex tachycardia

Question 4

What is dangerous about having an enlarged heart?

Answer 4

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

Question 5

How much does 1L of fluid weigh?

Answer 5

1 kg/2.2 lb

Question 6

What is the etiology of CHF?

Answer 6

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

Question 7

What is idiopathic cardiomyopathy?

Answer 7

Enlargement of the heart with no known cause

Question 8

What is cardio output?

Answer 8

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

Question 9

What is cardiac index?

Answer 9

CO adjusted for BSA

Question 10

Where does the afterload of the LV comes from?

Answer 10

The aorta

Constricted aorta -> high afterload

Question 11

Where does the afterload of the RV come from?

Answer 11

The pulmonary artery

Question 12

Where does central venous pressure come from?

Answer 12

RA

Question 13

What is a normal CVP (preload RV)?

Answer 13

2-8 mmHg

Question 14

What is a normal PAWP (preload LV)?

Answer 14

6-12 mmHg

Question 15

What is a normal SVR (afterload LV)?

Answer 15

800-1200 dynes/sec/cm

Question 16

What is a normal PVR (afterload RV)?

Answer 16

<250 dynes/sec/cm

Question 17

How should a nurse respond to a high CVP?

Answer 17

Taking off fluid because there’s overload

Question 18

How should a nurse response to a low CVP?

Answer 18

Isotonic solution

Question 19

What is PAWP?

Answer 19

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

Question 20

What is SVR?

Answer 20

Systemic vascular resistance

Afterload of LV

Question 21

What could a high SVR indicate?

Answer 21

Stenosis or vasoconstriction pressent

Question 22

What could a low afterload/SVR indicate?

Answer 22

Vasodilation

Question 23

What is PVR?

Answer 23

Pulmonary vascular resistance

Afterload of RV

Question 24

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

Answer 24

CVP/PAWP

Question 25

What is cardiac output?

Answer 25

HR x SV

Question 26

What can lead to increased preload?

Answer 26

Aortic regurgitation | Ventricular septal defect

Question 27

What can lead to increased afterload?

Answer 27

(Leftover volume) Aortic stenosis HTN

Question 28

What can lead to decreased contractility?

Answer 28

MI | Cardiomyopathy

Question 29

What can cause systolic HF?

Answer 29

``` Impaired contraction (MI) Increased afterload (HTN) Mechanical abnormality (valve disease) ```

Question 30

What is a hallmark sign of systolic HF?

Answer 30

Decreased LV EF

Question 31

What is the EF in systolic HF?

Answer 31

<45%

Question 32

Who is more commonly affected in systolic HF?

Answer 32

Men>women

Question 33

What can cause diastolic HF?

Answer 33

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

Question 34

What are 2 hallmark signs of diastolic HF?

Answer 34

Decreased stroke volume and CO | HF with normal EF

Question 35

Who is more commonly affected in diastolic HF?

Answer 35

Women>men

Question 36

What are 3 compensatory mechanisms for CHF?

Answer 36

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

Question 37

What are symptoms of left-sided heart failure?

Answer 37

``` Fatigue Edema Weight gain Cough Dyspnea Sleeplessness Angina Palpitations ```

Question 38

What are symptoms of right-sided heart failure?

Answer 38

``` Fatigue Edema Dyspnea in extreme late-stage Sleeplessness Angina Palpitations ```

Question 39

How do you manage HF?

Answer 39

Lifestyle mod | Symptom monitoring

Question 40

What are pharmacological treatments for HF?

Answer 40

``` ACEIs Diuretics Beta blockers Digoxin/Lanoxin ARBs Morphine Anticoagulants ```

Question 41

What are ACEIs and what do they do?

Answer 41

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

Question 42

What are some examples of diuretics?

Answer 42

Thiazides and loops | HCTZ or furosemide/Lasix

Question 43

What are beta blockers?

Answer 43

"olol" drugs

Question 44

What are Digoxin/Lanoxin and what do they do?

Answer 44

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

Question 45

What are ARBs and what do they do?

Answer 45

Angiotensin II receptor blockers "sartan" drugs Lower BP

Question 46

What will you see in left-sided HF?

Answer 46

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

Question 47

What will you see in right-sided HF?

Answer 47

Peripheral edema Ascites JVD