Congestive Heart Failure Flashcards

1
Q

What is Heart failure?

A

-A condition where the heart is not able to pump well enough to meet the bodies needs
-It can involve right, left, or both sides of the heart
-The left side of the heart usually fails first since it has to pump aginist greater resistance than the right ventricle

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2
Q

Some common conditions that make Heart failure more likely

A

-Arrhythmia
-CAD
-Diabetes Mellitus
-Pharmacy and thyrotoxicosis
-Pulmonary embolism (can cause right side heart failure)
-MI

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3
Q

Right side heart failure

A

-When the ability of the RV to contract is inspired (I.e. RV MI, pulmonary embolus)
-Blood pools in the RV and eventually the RA causing pressure and congestion in the vena cavae and systemic circulation

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4
Q

Left sided heart failure

A

-Blood backs into LV due to poor LV function
-As pumping ability is decreased blood is not fully pumped out of the LV
-Blood backs up from the LA to pulmonary veins and can eventually cause pulmonary edema
-Without treatment the blood will back up into RV and cause right sided heart failure as well

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5
Q

Common causes of LV failure

A

-Aortic or mitral valve stenosis or regurgitation
-Hypertension
-LV MI

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6
Q

Forward failure

A

-caused by increased afterload (I.e. in hypertension)
-When afterload increases, the LV can’t eject as much blood as usual, therefore there is decreased flow to the vital organs

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7
Q

Backward failure

A

-Results when the LV fails to empty completely, leftover blood then accumulates in the LV and lungs can lead to right sided heart failure

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8
Q

Acute heart failure

A

-S and S are new
-Typically Na+ and water retention have not occurred yet

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9
Q

Chronic heart failure

A

-S and S have been present for an extended period
-Fluid volume is increased

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10
Q

Heart failure primary prevention

A

-Primary prevention = modifying risk factors such as:
-Salt intake
-Weight
-Lack of exercise
-Smoking
-Stress

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11
Q

Heart failure secondary prevention

A

-Treating CAD
-Preventing MI
-Treating anemia
-Treating infections

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12
Q

Heart failure early signs

A

-Exertional, nocturnal or paroxysmal Dyspnea
-Fatigue
-Hepatomegaly

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13
Q

Heart Failure Late signs

A

-Anorexia
-Chest tightness
-Cyanosis
-Dependent edema
-Diaphoresis
-Dulness over lung bases
-Hemoptysis
-Hypotension
-Inspiratory crackles
-Hepatomegaly
-Narrow pulse pressure
-Nausea
-Oliguria
-Pallor
-Palpitations
-Pitting ankle edema
-S3
-Decreased LOC
-Tachypnea
-Unexplained steady weight gain

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14
Q

Goals in management of heart failure

A
  1. Decreasing intravascular volume
    2.Decreasing venous return
  2. Decreasing after-load
  3. Improving oxygenation and gas exchange
  4. Improving cardiac function
  5. Reducing anxiety
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15
Q

Improving pump preformance

A

-Cardiac glycosides
-Other positive inotropics

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16
Q

Reducing cardiac workload

A

-Vasodilators
-Anxiety reduction
-Rest
-Wt reduction

17
Q

Controlling salt and water retention

A

-Diuretics
-Low sodium diets
-Mechanical fluid removal

18
Q

Increasing oxygenation

A

-Oxygen therapy

19
Q

Collaborative Management; Acute CHF

A

-Treat underlying cause
-High Fowler’s position
-O2
-Cardiac monitor and O2 sat
-Morphine, lasix, nitroglycerin, inotropic therapy
-Vs q15min-q1h
-Daily weights
-Pt teaching

20
Q

Collaborative Management; Chronic CHF

A

-Treat underlying cause
-O2 therapy
-Rest
-Daily weights
-Sodium restricted diet
-Pt teaching

21
Q

Diagnostics; Heart failure

A

-History and Physical Assesment
-Determination of underlying cause
-CXR
-Echocardiography
-ECG
-Cardiac catheterization

22
Q

Complications of heart failure

A

Most common are;
-Arrhythmias
-Pulmonary edema
-Cardiogenic shock

23
Q

Patient teaching: heart failure

A

-Key points
-Diet
-Weight loss
-Medications
-Activity levels
-S + S