Done Dysrhythmias and Heart failure (10)

Question 1

What is heart failure?

Answer 1

Heart can’t pump enough blood to meet the demands of the body.

When the heart fails, cardiac output decreases and peripheral tissue does not get oxygen and nutrients.

Question 2

What are the clinical manifestations of right-sided failure?

Answer 2

Related to fluid accumulation of the peripheral tissues

JVD
Hepatomegaly
Ascites
Anorexia
Weakness
Pitting Edema: seen after 10 lb of fluid gain

Hand / leg 2+ edema!!!!!!!

Question 3

Left sided heart failure related to?

normal EF is?

symptoms?

Answer 3

Decreased cardiac output
Pulmonary congestion

Normal EF is 55-60%

Hacking cough, worse at night
Dyspnea on exertion
Orthopnea
Crackles

Question 4

What is the best way to determine fluid gain/loss? How?

Answer 4

weight gain of 3 lbs. in 2 days or
3-5 lbs. in a week

Daily weights

Same scale
same time of day
Same amount of clothing

Question 5

What is the purpose of an INR?

Answer 5

how much time it takes for blood to clot.

Normal INR- 0.8-1.1

Question 6

Digoxin:
How does the drug work?

+I DIG CD-

Answer 6

Increases the force of the contraction
Decreases heart rate

Question 7

When would you hold digoxin?

Answer 7

low potassium + low heart rate

Question 8

Clinical manifestations of dig toxicity?

Answer 8

ANOREXIA, NAUSEA, VOMITING!!!!

Yellow or green haze

Bradycardia
Arrhythmias/dysrhythmias
Heart block

Question 9

Why are older adults at a greater risk for developing digoxin toxicity?

Answer 9

Due to normal age-related renal changes.

Renal and hepatic dysfunction can increase the risk of digoxin toxicity

Question 10

What is the relationship between potassium levels and digoxin toxicity?

Answer 10

Hypokalemia increases the risk of digoxin toxicity.

Hypokalemia enhances the effects of digoxin.

Hypokalemia may occur with use of some diuretics

Question 11

Nursing considerations when administering digoxin?

Monitor what before administering?
Withhold if?
Take dig when?
Observe?
If administered IV?
Monitor?
Assess for?

Answer 11

*Monitor apical pulse for one full minute before administration.

Withhold dose and notify provider if pulse is less than 60

Instruct patient to take Dig the same time everyday.

Observe IV site for redness and irritation. Digoxin can cause extravasation.

If administered IV, monitor EKG/ECG

Monitor intake and output daily.

Assess for fall risks in older adults - dig causes vasodilation