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NURS 310 - Exam 3 > Chronic Heart Failure > Flashcards

Chronic Heart Failure Flashcards

1
Q

______ refers to resistance caused by ejection of blood from the ventricle

A

Afterload

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2
Q

______ refers to cardiac muscle stretching at the end of diastole

A

Preload

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3
Q

______ refers to the product of cardiac output multiplied by peripheral resistance

A

BP

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4
Q

______ refers to the amount of blood pumped by each ventricle

A

Cardiac output

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5
Q

_______ is a syndrome of structural / functional cardiac disorders

A

Heart failure

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6
Q

Describe heart failure (3)

A
  • Inability to pump enough blood to meet metabolic demands
  • Impaired ejection of blood (systole)
  • Impaired filling of the ventricles (diastole)
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7
Q

What is congestive heart failure?

A

Chronic fluid overload (congestion)

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8
Q

What are the manifestations of acute decompensated heart failure? (2)

A
  • Severe respiratory distress
  • Poor systemic perfusion
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9
Q

______ results from weakened heart muscle

A

Systolic heart failure (HFrEF)

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10
Q

______ results from stiff / noncompliant heart tissue

A

Diastolic heart failure (HFpEF)

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11
Q

______ is the percentage of blood volume in the ventricles at the end of diastole

A

Ejection fraction

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12
Q

Normal ejection fraction is ______

A

50% - 70%

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13
Q

EF is a measurement of ______

A

Contractility

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14
Q

EF is ______ in systolic heart failure

A

Decreased

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15
Q

Left-sided heart failure often leads to ______

A

Right-sided heart failure

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16
Q

What are the compensatory mechanisms for chronic heart failure? (3)

A
  • SNS stimulation
  • Renin-angiotensin aldosterone system
  • Myocardial hypertrophy
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17
Q

Describe SNS stimulation (3)

A
  • Release of epinephrine / norepinephrine
  • Increased heart rate
  • Vasoconstriction
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18
Q

Describe renin-angiotensin aldosterone system activation (3)

A
  • Sodium / fluid retention
  • Increased blood volume
  • Vasodilation
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19
Q

To counteract increased cardiac workload, atrial natriuretic peptide (ANP) and ______ are released from the heart

A

B-type natriuretic peptide (BNP)

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20
Q

What condition is a the primary cause of right-sided heart failure?

A

Pulmonary hypertension

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21
Q

Weight gain of ______ in one day is a concern associated with heart failure / fluid retention

A

2 - 3 lbs

22
Q

Weight gain of ______ in one week is a concern associated with heart failure / fluid retention

A

5 lbs

23
Q

What are the manifestations of chronic heart failure? (3)

A
  • Dyspnea
  • Fatigue
  • Fluid retention
24
Q

How can fluid retention occur in chronic heart failure? (2)

A
  • Pulmonary edema
  • Peripheral edema
25
Q

S3 can be heard in which type of heart failure due to abnormal filling?

A

Left-sided heart failure

26
Q

What are the manifestations of left-sided heart failure? (5)

A
  • Cold skin
  • Cyanosis
  • Crackles
  • Nocturia
  • Diminished pulses
27
Q

Left-sided heart failure is characterized by ______

A

Pulmonary congestion

28
Q

Describe the pathophysiology of pulmonary congestion associated with left-sided heart failure (3)

A
  • Left ventricle unable to pump effectively
  • Backflow of blood into lungs / alveoli
  • Causes pulmonary edema / impaired gas exchange
29
Q

What are the manifestations of right-sided heart failure? (5)

A
  • Ascites
  • Anorexia / nausea
  • Dependent edema
  • Hepatomegaly
  • JVD
30
Q

Right-sided heart failure is characterized by ______

A

Peripheral congestion

31
Q

What is the primary laboratory value associated with the diagnosis of heart failure?

A

BNP > 100

32
Q

What is the primary diagnostic test associated with the diagnosis of heart failure?

A

Echocardiogram showing abnormal EF (normal range = 50% - 70%)

33
Q

Treatment of heart failure requires the concurrent use of what types of medications? (3)

A
  • Diuretics
  • ACE inhibitors / ARBs
  • Beta blockers
34
Q

Describe the MOA of diuretics used for heart failure

A

Decrease fluid

35
Q

What types of diuretics are used for the treatment of heart failure? (3)

A
  • Loop - furosemide
  • Thiazide - hydrochlorothiazide
  • Potassium-sparing - spironolactone
36
Q

Describe the MOA of ACE inhibitors / ARBs used for heart failure (2)

A
  • Decrease BP
  • Decrease afterload
37
Q

What types of ACE / ARBs are used for the treatment of heart failure? (2)

A
  • ACE inhibitor - lisinopril
  • ARB - valsartan
38
Q

Describe the MOA of beta blockers used for heart failure (2)

A
  • Vasodilation
  • Decrease afterload
39
Q

What types of beta blockers are used for the treatment of heart failure? (2)

A
  • metoprolol tartrate
  • metoprolol succinate
40
Q

Describe nutritional therapy used for heart failure (2)

A
  • Low sodium diet - 2 grams
  • Fluid restriction - 2 liters
41
Q

______ may be needed to decrease pulmonary congestion caused by heart failure

A

Supplemental oxygen

42
Q

What complications are associated with chronic heart failure? (6)

A
  • Hypotension
  • Cardiogenic shock
  • Pericardial effusion
  • Pulmonary edema
  • Cardiac tamponade
  • Cardiac arrest
43
Q

What is cardiogenic shock?

A

Heart cannot pump enough blood

44
Q

Cardiogenic shock is often caused by ______

A

Severe MI

45
Q

What is pericardial effusion?

A

Fluid in pericardium

46
Q

What are the manifestations of pulmonary edema? (4)

A
  • Coughing with pink, frothy sputum
  • Cyanosis
  • Tachycardia
  • Tachypnea
47
Q

Pulmonary edema is …

A

An emergent situation

48
Q

What is cardiac tamponade?

A

Increased pressure on the heart

49
Q

Cardiac tamponade is caused by ______

A

Pericardial effusion

50
Q

What is the primary manifestation of cardiac tamponade?

A

Distant / muffled heart sounds

NURS 310 - Exam 3 (9 decks)

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