CMO & HF

Question 1

left sided HF patho

Answer 1

left ventricle systolic dysfunction: fluid backs up into lungs, impaired gas exchange

left ventricle diastolic dysfunction: stiff/thick LV, fluid backs into lungs

Question 2

right sided HF patho

Answer 2

RV systolic dysfunction: thin/weak, back up of fluid in venous circulation

RV diastolic dysfunction: stiff/thick, back up of lfuid in venous circulation

Question 3

patho/symptoms/treatment for dilated CMO

Answer 3

fibrosis of myocardium, dilated chambers

S/sx: fatigue, dysrhythmias, left sided HF
S3 & S4

Tx: treat HF, vasodilator, transplant

Question 4

patho/symptoms/treatment for hypertrophic CMO

Answer 4

hypertrophy of walls

S/sx: angina, syncope, S4, sudden common death

Tx: BB, mitral valve replacement, Dig, nitro

Question 5

patho/symptoms/treatment of restrictive CMO

Answer 5

fibrosed walls cant expand or contract

S/sx: right sided HF, heart block, emboli, S3 & S4

Tx: exercise restrictions

Question 6

systolic vs. diastolic dysfunction

Answer 6

systolic: impaired contractility, thin/weak heart muscle, low EF, S3 gallop

diastolic: impaired filling/relaxation, stiff/thick, normal EF, S4 gallop

Question 7

what’s a normal ejection fraction?

Answer 7

> 50-60%

Question 8

causes of CMO/HF

Answer 8

myocardial damage, valvular disorders, arrhythmias, conduction defects, reduced substrate availability, infiltrative or matrix disorders, disorders that increase demand for CO, disorders that increase resistance to output (afterload)

Question 9

how to calculate CO?

Answer 9

HR x SV/1000

Question 10

disease course and findings for left sided HF

Answer 10

crackles, cough, pulmonary congestion, orthopnea

Question 11

disease course and findings for right sided HF

Answer 11

peripheral edema, weight gain, JVD, abdominal ascites, n/v

cor pulmonale: when rt sided HF is caused by pulmonary HTN

Question 12

meds

Answer 12

goal: decrease afterload, preload, contractility

• digoxin
• ACE/ARBs
• BB
• oxygen
• nitrates
• CCB
• hydralazine
• diuretics

Question 13

labs

Answer 13

electrolytes, WBC, LFT, ferritin level, BNP, ABG, echocardiogram, chest x ray, cardiac cath, dig level

Question 14

nursing intervention

Answer 14

prevent exacerbations. smoking cessation, self management, take meds, stay active, weight each day, limit sodium/fluids, note new symptoms, avoid NSAIDs

immediately report symptoms of rapid weight gain, waking at night to pee, swelling, cold symptoms