exam 1 heart failure/ peripheral Flashcards
A condition in which the heart is unable to adequately pump blood throughout the body and/or unable to prevent blood from “backing up” into the lungs.
Heart failure
primary risk factors of Heart failure
coronary artery disease
Heart failure usually begins with
left ventricle systolic dysfunction
Failure of heart to pump blood forwards at a sufficient rate to meet metabolic demand
forward failure
ability to pump sufficient blood to meet metabolic demand only if cardiac filling pressures are abnormally high
backward demand
Shows congestion as white, dense areas, may show enlarged heart, liver congestion
CXR
what lab values are altered
serum BNP
diagnosis test that can be normal or could show ischemia, infarction, tach, hypertrophy,tamponade
ECG
tells about L and R vent function, abnormal contraction, valve problems
echocardiogram
used for patients with CAD
cardiac cath
ejection fraction >70%
high function
ejection fraction 55-70%
normal function
ejection fraction 40-55%
low function
ejection fraction
possible heart failure
BNP
unlikely to form CHF
BNP 100-500
may be CHF
BNP over 500
most consistent with CHF
what lung sound will you hear with heart failure
crackles
what heart sounds do you hear with heart failure
S3 or S4
what position would you place the patient in to reduce pulmonary congestion
high fowlers position
used to reduce afterload
vasodilators
used to increase ventricular contractility
inotropes
block vasoconstriction and aldosterone decrease systemic vascular resistance, after load, preload
Ace inhibitors
good for diastolic dysfunction, decrease heart rate to promote L atrium emptying and improve L vent volume, decrease myocardial O2 demand
beta blockers
given with clinical s/s overload, increases urinary output which leads to decrease blood volume, preload, and cardiac workload
diuretics
how much salt should they have a day
2 grams
what is the only thing they should take for pain
tylenol
no limitation of activities, no symptoms from ordinary activities
Class 1
Mid limitation of activity, comfortable with rest or mild exertion
class 2
marked limitation of activity, comfortable only at rest
class 3
any physical activity brings on discomfort and symptoms occurs at rest
class 4
progressive narrowing, degeneration, and obstruction of arteries of extremities, usually lower involved
chronic arterial occlusive disease
calf muscle pain occurring when muscle is forced to contract without adequate blood supply, pain is alleviated with rest
intermittent claudication
medication used for claudication
pentoxifylline and cilostazol
incision is made into the artery and the atheromatous obstruction is removed
Treatment of choice
endarterectomy
can occur in healthy and diseased arteries resulting from thrombosis, embolism in healthy artery or trauma
Occurs suddenly and without warning
acute arterial occlusive disease
surgical repair where they remove embolus from artery
embolectomy
graft from one femoral artery to other
femoral-femoral bypass
graft from femoral artery to popliteal artery
femoral-popliteal bypass
graft from aorta to iliac arteries
aortoiliac bypass
Episodic vasospastic disorder of the cutaneous arteries most often involving the fingers and toes
raynauds phenomenon
1st line therapy for raynauds phenomenon
sustained released calcium channel blockers
makes up Virchows triad
Stasis
Endothelial injury
hypercoagulation
develop in areas of slow or turbulent blood flow
thrombi
is criterion standard but is not always accurate
venogram
different degrees of compression to different parts of leg
graduated compression stockings
uses air pump by inflating and deflating sleeves at regular intervals to stimulate venous return
External pneumatic compression sleeves
is inserted into inferior vena cave to catch blood clots
greenfield
usually have brownish discoloration around the medial malleolus of the ankle
Skin is dry, cracked and itchy
Subcutaneous tissue is fibrotic and atrophied
stasis ulcers
A paste bandage with zinc oxide, glycerin, etc
Applied without tension distal to proximal to below knee
primary dressing applied first
Unna Boot
