CHF and Dysrhythmias

Question 1

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

Answer 1

Heart Failure

Question 2

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

Answer 2

systemic, pulmonary, output

Question 3

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

Answer 3

65

Question 4

is a potential consequence of most cardiac disorders

Answer 4

Heart failure

Question 5

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

Answer 5

myocardial ischemia; hypertension

Question 6

Dyspnea, pulmonary rates, cardiomegaly symptoms of _____

Answer 6

heart failure

Question 7

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

Answer 7

heart failure

Question 8

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

Answer 8

myocardial fibers

Question 9

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

Answer 9

MI

Question 10

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

Answer 10

systolic; ejection fraction

Question 11

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

Answer 11

cardiac muscle cells, and reduced ATP production

Question 12

What are the main 2 causes of diastolic dysfunction?

Answer 12

Coronary artery disease and hypertension are two main causes

Question 13

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

Answer 13

elderly, women and those without history of MI

Question 14

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

Answer 14

diastolic; myocardial relaxation

Question 15

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

Answer 15

cardiac output, edema, normal

Question 16

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

Answer 16

systolic

Question 17

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

Answer 17

Compensatory mechanisms/remodeling

Question 18

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

Answer 18

SNS activation
Increased preload
Myocardial hypertrophy

Question 19

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

Answer 19

baroreceptor; fall

Question 20

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

Answer 20

CNS; venoconstriction

Question 21

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

Answer 21

SNS; renin; sodium

Question 22

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

Answer 22

remodeling in SNS activation

Question 23

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

Answer 23

Increased Preload

Question 24

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

Answer 24

CO; conservation

Question 25

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

Answer 25

RAAS; volume

Question 26

increased preload causes damage in _____

Answer 26

heart failure

Question 27

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.

Answer 27

Frank Starling Mechanism

Question 28

Frank Starling Mechanism is associated with ______

Answer 28

increased preload

Question 29

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

Answer 29

myocardial. Law of Laplace

Question 30

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

Answer 30

systolic; afterload

Question 31

________ factors have hypertrophic effect on the heart

Answer 31

Neurohormonal

Question 32

________ is involved in remodeling

Answer 32

Angiotensin II

Question 33

_____ventricular failure most common, often leads to _____ventricular failure

Answer 33

left; right

Question 34

Resulting from insufficient cardiac pumping manifested by poor CO

Answer 34

Forward failure

Question 35

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

Answer 35

cardiac output

Question 36

Congestion of blood behind the pumping chamber

Answer 36

Backward failure

Question 37

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

Answer 37

left; backward

Question 38

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

Answer 38

backwards; left

Question 39

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

Answer 39

backwards; left

Question 40

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

Answer 40

Forward; left

Question 41

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

Answer 41

life threatening; left

Question 42

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

Answer 42

Shortness of breath

Question 43

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

Answer 43

decreased; increased

Question 44

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

Answer 44

increased; increased, increased

Question 45

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

Answer 45

decreased; decreased

Question 46

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

Answer 46

RAAS; cardiac output

Question 47

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

Answer 47

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

Question 48

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

Answer 48

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

Question 49

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

Answer 49

right heart failure

Question 50

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

Answer 50

Backwards; systemic

Question 51

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

Answer 51

forward; output

Question 52

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

Answer 52

backward; right

Question 53

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

Answer 53

decreased, increased, increased

Question 54

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

Answer 54

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

Question 55

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

Answer 55

RAAS; fluid

Question 56

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

Answer 56

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

Question 57

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

Answer 57

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

Question 58

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

Answer 58

Hepatojugular reflex test

Question 59

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

Answer 59

Biventricular heart failure

Question 60

In biventricular heart failure there is reduced ____

Answer 60

CO

Question 61

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

Answer 61

pulmonary; systemic venous

Question 62

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

Answer 62

CO

Question 63

Obtained by manipulating preload, afterload, and contractility

Answer 63

Treatment for heart failure

Question 64

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

Answer 64

preload; ACE

Question 65

Diagnostic assessment of HF includes ______ and _____

Answer 65

xray; echocardiography

Question 66

What does FACES stand for? What is it for?

Answer 66

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

Question 67

______natriuretic peptide level used to identify heart failure

Answer 67

B type

Question 68

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

Answer 68

SNS; beta

Question 69

Treatment for heart failure includes improving ____ digitalis

Answer 69

CO

Question 70

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

Answer 70

Ang 2; ARBS

Question 71

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

Answer 71

heart failure

Question 72

______synchronize ventricular contraction. They are used in treatment of ______

Answer 72

pacemakers; heart failure

Question 73

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

Answer 73

backwards effects

Question 74

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

Answer 74

forward effects