Exam 2 Flashcards
What is heart failure?
Inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients.
Systolic dysfunction is
problem with contraction of the heart
Diastolic dysfunction is
problem with filling the heart
What is “Left-Sided” heart failure?
When the left ventricular cannot pump blood out efficiently into the aorta and the systemic circulation.
this leads to pulmonary congestion
What is “right-Sided” heart failure?
When the right ventricle fails and cannot eject blood or accommodate all the blood flowing in from VC.
What is the pathway that leads to HF?
-Systolic HF (not enough blood going out to body)
-sympathetic NS stimulated epinephrine and norepinephrine
-Decrease in kidney perfusions stimulates RASS system to increase BP and retain fluid
-Reduction on contractility of muscle fibers in heart due to increased work load
-Heart compensates for increased workload which increased thickness of heart muscle.
What are different things that can cause HF?
-Coronary artery disease (atherosclerosis)
-Ischema
-Cardiomyopathy
-Systemic or pulmonary hypertension
-Valvular heart disease
What are the manifestations of “Left-sided” heart failure?
-Dyspnea (SOB)
-Cough - dry nonproductive
-Crackles
-Low oxygen levels
What are the manifestations of “right-sided” heart failure?
-Edema
-Peripheral
-JVD
-Enlargement of the liver (due to venous engorgement)
-GI distress (due to build-up of fluid and extra pressure)
-Loss of appetite due to engorgement of GI organs.
How is HF diagnosed?
ECG
Chest Xray
Sonograms
Stress test
PET scan
Cardiac catherterization
What labs are being asses with HF?
-Liver enzymes
-Cardiac drug levels (Digoxin)
-Bleeding / clotting times
-Electrolytes
-Pulse oximetry
-ABGs
-BUN/Creatinine
-Serum albumin
-CBC
-ESR
-Thyroid studies
What are medications used to treat HF
-RAAS inhibitors (ACEi, ARB, Aldosterone, Reinin inhibitors)
-Beta Blockers
-Calcium Channel Blockers
-Diuretics
-Dilators
-Digoxin
CAN therapies for HF
-Restrict Sodium
-Supplemental Oxygen
-CRT (pacemaker)
-Ultrafiltration (for pts with severe fluid overlaod)
-Cardiac transplant
How should a nurse assess for HF?
-Auscultate lung sounds
-Auscultate for S3 heart sounds
-Assess for JVD
-LOC
-Liver for hepatojugular reflux
-Measure I/O
-daily weight
What is Hypertension?
Any BP over 140/90
***based on average of 2 or more accurate BP measurements during 2+ consultations with the provider.
What is a Normal BP
Systolic: >120
Diastolic: >80
What is prehypertension / elevated BP range
Systolic: 120-129
Diastolic: >80
What is Stage 1 Hypertension?
Systolic: 130-139
Diastolic: 80-89
What is Stage 2 Hyptertension?
Systolic: 140 or higher
Diastolic: 90 or higher
What is Hypertensive Crisis?
Systolic: higher than 180
Diastolic: Higher than 120
What are different factors / causes for hypertension?
-Excess sodium (increased body to hold onto water)
-Obesity
-Genetic Alteration
-Increase in sympathetic NS
-Increase in renal reabsorption
-Increase in RAAS
-Decreased vasodilation (due to damage)
How does hypertension manifest?
-headache (Oxygen is not getting to the brain)
-Dizziness (Oxygen is not getting to the brain)
-Chest Pain (decreased Oxygen)
-Blurred vision (too much constriction of blood vessels in the eye)
What are some client education on how to prevent hypertension?
-Weight Reduction
-DASH diet (heavy in fruits and veggies and l ow in fat dairy)
-Reduce salt
-increase physical activity
-reduce alcohol to no more than 2 drinks per day (men) 1 (women)
What can hypertension lead to?
-Heart failure
-MI
-Impaired vision
-Renal failure