Congestive Heart Failure

Question 1

what is Defined as the hearts inability to pump enough blood throughout the body.

Answer 1

Congestive Heart Failure

Question 2

Heart failure may be right sided or left sided and systolic or diastolic Left sided refers to

Answer 2

left ventricle being the problem

Question 3

Heart failure may be right sided or left sided and systolic or diastolic Right sided refers to

Answer 3

right ventricle being the problem

Question 4

______ refers to that ventricle not contracting well leading to decreased cardiac output from that ventricle.

Answer 4

Systolic

Question 5

______ refers to that ventricle no being able to distend well in order to receive adequate blood volume from the atrium.

Answer 5

Diastolic

Question 6

What is the most common type of CHF

Answer 6

left ventricular systolic failure

Question 7

The most common cause of right heart failure is _____

Answer 7

left heart failure

Question 8

Symptoms of what sided CHF:
The pressure is backing up into the lungs so
symptoms will be dyspnea, orthopnea, dyspnea on exertion, pulmonary edema, chronic non-productive cough, exercise intolerance, fatigue.

Answer 8

Left sided

Question 9

Symptoms of what sided CHF:
The pressure is backing up into the venous system so symptoms will be due to fluid retention, peripheral edema, hepatic congestion, abdominal ascites.

Answer 9

Right sided symptoms

Question 10

PE findings of what?
JVD, elevated JVP, Hepatomegaly, Ascites (fluid wave on abdominal examination), peripheral pitting edema.

Answer 10

Right sided

Question 11

PE findings of what?
Crackles in bases of lungs, pleural effusions, expiratory wheezing or rhonchi, Enlarged sustained LV impulse, Decreased S1, murmurs, S3, hypoxemia, displaced apical impulse.

Answer 11

Left sided

Question 12

What labs would you order for suspected CHF

Answer 12

BUN/Creatinine, LFTs, electrolytes

Question 13

You’re using a CXR to look for what?

Answer 13

To look for cardiomegaly, pleural effusions, pulmonary edema

Question 14

Acute Exacerbation treatment

Answer 14

IV, O2 vitals, foley cath
Correct any reversible causes(AMI, HTN, Arrhythmia)
Diuretics

Question 15

What Diuretics would you give?

Answer 15

Furosemide (Lasix) 40 mg IV, if inadequate urine output in 30 minutes then repeat the dose
or
Bumetanide (Bumex) 1 mg IV, if inadequate urine output in 30 minutes then repeat the dose.

Question 16

CHF has a Poor prognosis: 2 year mortality is 35% and 6 year is 80%, if pulmonary edema present then ____ mortality in the next _____.

Answer 16

50%, 1 year.