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PATHO EXAM 2 > CHF and Dysrhythmias > Flashcards

CHF and Dysrhythmias Flashcards

1
Q

Inability of heart to maintain sufficient cardiac output to meet metabolic demands of tissues and organs

A

Heart Failure

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2
Q

Heart failure results in congestion of blood flow in the ____or _______ venous circulation, inability to increase cardiac _____to meet the demands of activity or increased tissue metabolism

A

systemic, pulmonary, output

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3
Q

There is an increase in incidence of congestive heart failure among people over ____ years

A

65

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4
Q

is a potential consequence of most cardiac disorders

A

Heart failure

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5
Q

Most common cause of heart failure is ______followed by ______and dilated cardiomyopathy

A

myocardial ischemia; hypertension

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6
Q

Dyspnea, pulmonary rates, cardiomegaly symptoms of _____

A

heart failure

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7
Q

Pulmonary edema, S3 heart sound, and tachycardia signs of ______

A

heart failure

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8
Q

Heart failure results from impaired ability of ________ to contract, relax, or both

A

myocardial fibers

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9
Q

______ is a common etiology in Systolic Dysfunction of heart failure.

A

MI

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10
Q

In _______ dysfunction, reduced contractility evidenced by low _______ and reduced inotropy during ventricular systole

A

systolic; ejection fraction

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11
Q

In systolic dysfunction of heart failure, impaired contractility involves loss of _______, B receptor down regulation, and reduced ____ production

A

cardiac muscle cells, and reduced ATP production

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12
Q

What are the main 2 causes of diastolic dysfunction?

A

Coronary artery disease and hypertension are two main causes

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13
Q

Diastolic dysfunction in heart failure is more likely to develop in __________

A

elderly, women and those without history of MI

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14
Q

In _____ dysfunction, there is a disorder of _______ such that the ventricle is excessively noncompliant and does not fill effectively.

A

diastolic; myocardial relaxation

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15
Q

In diastolic dysfunction, there is low ______, congestion, and ______formation with ______ejection fraction

A

cardiac output, edema, normal

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16
Q

A nurse reads in the chart that a patient has an ejection fraction of 15%. This is consistent with a diagnosis of _____ heart failure.

diastolic
systolic
ectopic
vasovagal

A

systolic

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17
Q

Helpful in restoring cardiac output toward normal, but over the long term are detrimental to the heart

A

Compensatory mechanisms/remodeling

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18
Q

Current management of HF directed toward reducing the harmful consequences of these compensatory responses: (3)

A

SNS activation
Increased preload
Myocardial hypertrophy

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19
Q

Sympathetic nervous system activation is primarily a result of _______reflex stimulation, which detects ____in pressure

A

baroreceptor; fall

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20
Q

In SNS activation, _____ increases activity in the sympathetic nerves to the heart resulting in ______

A

CNS; venoconstriction

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21
Q

in ______ activation, juxtaglomerular cells release _____activating the RAAS cascade, resulting in increased_____ and water retention

A

SNS; renin; sodium

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22
Q

Process of myocyte loss, hypertrophy of remaining cells, and interstitial fibrosis are components of ________, in _____activation

A

remodeling in SNS activation

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23
Q

Initially a consequence of reduced EF with resultant increase in residual ESV

A

Increased Preload

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24
Q

In increased preload, there is decreased ____ to the kidney and reduced glomerular filtration = fluid _____

A

CO; conservation

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25
Q

In increased preload, the _____cascade is activated which = elevated blood _____

A

RAAS; volume

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26
Q

increased preload causes damage in _____

A

heart failure

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27
Q

States that the stroke volume of the left ventricle will increase as the left ventricular volume increases due to the myocyte stretch causing a more forceful systolic contraction.

A

Frank Starling Mechanism

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28
Q

Frank Starling Mechanism is associated with ______

A

increased preload

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29
Q

Myocardial Hypertrophy/Remodeling results from a chronic elevation of ________ wall tension. This is the ______

A

myocardial. Law of Laplace

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30
Q

In Myocardial Hypertrophy/Remodeling there is high ________pressure in the ventricle needed to overcome a high _______leading to hypertrophy.

A

systolic; afterload

31
Q

________ factors have hypertrophic effect on the heart

A

Neurohormonal

32
Q

________ is involved in remodeling

A

Angiotensin II

33
Q

_____ventricular failure most common, often leads to _____ventricular failure

A

left; right

34
Q

Resulting from insufficient cardiac pumping manifested by poor CO

A

Forward failure

35
Q

Insufficient _______may be manifested as confusion, fatigue, tachycardia, reduced urine output, and poor peripheral circulation

A

cardiac output

36
Q

Congestion of blood behind the pumping chamber

A

Backward failure

37
Q

In ______sided heart failure, ______effects result in accumulation of blood within the pulmonary circulation, pulmonary congestion, and edema

A

left; backward

38
Q

The following are results of _______effects in _____ sided heart failure
Dyspnea, dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea

A

backwards; left

39
Q

The following are results of _______effects in _____ sided heart failure
Cough, respiratory crackles (rales), hypoxemia, and high left-atrial pressure, cyanosis

A

backwards; left

40
Q

______effects in ______sided heart failure results in result in insufficient CO with diminished delivery of oxygen and nutrients to peripheral tissues and organs

A

Forward; left

41
Q

Acute cardiogenic pulmonary edema is a ________ condition; happens in _____ sided heart failure

A

life threatening; left

42
Q

Which of the following is a finding unique to left-sided heart failure?

Decreased urine output
Increased heart rate
Peripheral dependent edema
Shortness of breath

A

Shortness of breath

43
Q

In the backwards effects of left ventricular failure, there is _____ ejection fraction and _______left ventricular preload

A

decreased; increased

44
Q

In the backwards effects of left ventricular failure, there is _________left atrial pressure, ________pulmonary pressure, and _______right ventricular afterload

A

increased; increased, increased

45
Q

In the forward effects of left sided heart failure, there is ______cardiac output and ______ tissue perfusion

A

decreased; decreased

46
Q

In the forward effects of left sided heart failure, there is _____ activation after decreased _____

A

RAAS; cardiac output

47
Q

Backwards effects of L sided heart failure include (NAME 6)

A

Dyspnea, orthopnea, cough, Nocturnal dyspnea, Cyanosis, Crackles

48
Q

Forward effects of L sided heart failure include ____(7)_____

A

Fatigue, oliguria, increased heart rate, faint pulses, restlessness, confusion, anxiety

49
Q

Pulmonary disorders—increased pulmonary vascular resistance—high afterload—right ventricular hypertrophy (cor pulmonale)—right ventricular failure
associated with _________

A

right heart failure

50
Q

______effects of right heart failure due to congestion in the _______- venous system

A

Backwards; systemic

51
Q

________ effects in right heart failure cause low _____to left ventricle leading to low CO

A

forward; output

52
Q

Edema, ascites, jugular veins distended, impaired mental functioning, hepatomegaly, splenomegaly are all symptoms of ______effects in ______ heart failure

A

backward; right

53
Q

Backward effects in right sided heart failure include _______ejection fraction, _______right ventricular preload, and ______right atrial pressure

A

decreased, increased, increased

54
Q

Forward effects in right sided heart failure include decreased ____(3)____

A

Output to left ventricle, left ventricular cardiac output, and tissue perfusion

55
Q

Forward effects in right heart failure leads to _____ activation, leading to _____ retention

A

RAAS; fluid

56
Q

Backward effects of right sided heart failure include ________(6)_____

A

Hepatomegaly, splenomegaly, ascites, anorexia, subcutaneous edema, jugular vein distention

57
Q

Forward effects of right heart failure include _______(6)_____

A

Fatigue, oliguria, increased HR, faint pulses, restlessness, confusion, anxiety

58
Q

Looks for the distension of the neck veins in backward effects of right sided heart failure

A

Hepatojugular reflex test

59
Q

Most often result of primary left-sided HF progressing to right-sided HF

A

Biventricular heart failure

60
Q

In biventricular heart failure there is reduced ____

A

CO

61
Q

In biventricular heart failure, there is _____ congestion due to left sided HF and _____ congestion due to right sided HF

A

pulmonary; systemic venous

62
Q

Treatment for HF is aimed at improving ______while minimizing congestive symptoms and cardiac workload

A

CO

63
Q

Obtained by manipulating preload, afterload, and contractility

A

Treatment for heart failure

64
Q

In treatment for HF, reducing _______ reduces intravascular volume with diuretics and ____ inhibitors, modify fluid and salt intake

A

preload; ACE

65
Q

Diagnostic assessment of HF includes ______ and _____

A

xray; echocardiography

66
Q

What does FACES stand for? What is it for?

A

(fatigue, activity limitation, congestion, edema, shortness of breath); identifying signs of heart failure

67
Q

______natriuretic peptide level used to identify heart failure

A

B type

68
Q

Treatment for heart failure includes inhibiting _____ effects by using _____ blockers

A

SNS; beta

69
Q

Treatment for heart failure includes improving ____ digitalis

A

CO

70
Q

Treatment for heart failure includes reducing the effects of _______ by using ACE inhibitors and ______

A

Ang 2; ARBS

71
Q

Improving contractility—digitalis or other cardiac glycoside, β agonists (not for long-term use) is used in treatment for

A

heart failure

72
Q

______synchronize ventricular contraction. They are used in treatment of ______

A

pacemakers; heart failure

73
Q

Occurs when the ventricle does not pump out all the blood that comes in

A

backwards effects

74
Q

Occurs when the heart is not pumping out enough blood needed by the body

A

forward effects

PATHO EXAM 2 (12 decks)

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