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NURS 201: Advanced Adult Health > Exam 3: Heart Failure > Flashcards

Exam 3: Heart Failure Flashcards

1
Q

describe heart failure

A

heart stopped working; either not pumping/decreased pumping or not filling

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2
Q

decreased pumping of the heart is which type of HF

A

systolic

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3
Q

not filling is what type of HF

A

diastolic

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4
Q

right side HF is which type of HF

A

systemic

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5
Q

list manifestations of right side HF

A

backs up into vena cava
visceral and peripheral edema
JVD
dependent edema
hepatomegaly
ascites
increased weight gain
increased peripheral venous pressure
anorexia and GI issues
periodical edema
systemic edema

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6
Q

left sided HF is which type of HF

A

pulmonary

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7
Q

manifestations of left sided HF

A

back up into lungs
wheezes
crackles
S3/ ventricular gallop
dyspnea on exertion
dry cough
decreased O2 sat
oliguria
paroxysmal, nocturnal dyspnea
exertion dyspnea
orthopnea
cyanosis

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8
Q

what is normal EF

A

50-70

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9
Q

what is reduced EF

A

40-49

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10
Q

what is failing EF

A

<40

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11
Q

what EF means a patient requires transplant

A

30%

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12
Q

preload is increased with what 2 things

A

increase with hypervolemia
increase with heart valve regurgitation

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13
Q

explain preload

A

volume of blood coming from sup/inf vena cava into the right atrium to right ventricle

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14
Q

after load is increased with what 2 things

A

increase with hypertension
increase with vasoconstriction

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15
Q

explain afterload

A

the resistance the left ventricle has to overcome to pump to aorta to the rest of the body

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16
Q

explain cardiac outload

A

volume of blood pumped per minute

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17
Q

explain BNP

A

biomarker for HF
>100 = HF

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18
Q

vasodilator
decrease afterload

A

ACE inhibitors

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19
Q

what do you monitor for with ACE inhibitors

A

Angioedema
Cough
Elevated K+

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20
Q

prescribed when ACEs cannot be used

A

ARBs

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21
Q

used in addition to ACEs

A

beta blockers

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22
Q

when are you not supposed to administer beta blockers

A

not within 2 hours of of ACEs
caution in patients with asthma

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23
Q

alternative to ACEs
anti-hypertensive
vasodilator

A

isosorbide nitrate

24
Q

increase contractility of heart

A

cardiac glycoside

25
what do you have to monitor for with cardiac glycosides
digoxin toxicity; especially with LOW K+
26
decrease preload decrease after load decrease BP only given IV
milrinone
27
what is a side effect of using milrinone
increased risk for dysrhythmia
28
used for left ventricular dysfunction increase contractility increase renal perfusion
dobutamine
29
treatment of HF: LMNOP
Lasix Morphine Nitrates O2 Pee (urine output)
30
treatment of HF: UNLOAD FAST
Upright position Nitrates Lasix O2 ACE inhibitors Digoxin Fluid decrease Afterload decrease Sodium decrease Test (labs)
31
anytime there is respiratory distress, what do we need to get?
ABGs
32
what does a pulmonary artery catheter assess?
heart function and fluid volume
33
PAC showing increased pressure means what
fluid overload
34
PAC showing decreased pressure means what
dehydration
35
what does pulmonary wedge pressure assess
the pressure between the pulmonary artery and lung
36
explain pericardial effusion
fluid around the heart, keeping the heart from pumping properly; you'll hear distant/ muffled heart sounds
37
what is a sign of pericardial effusion
pulsus paradox
38
explain pulsus paradox
decrease in BP >10 mmHg when taking a deep breath; engorged neck veins; decreased BP and increased SOB
39
untreated pericardial effusion leads to what
cardiac tamponade
40
explain cardiac tamponade
too much fluid around the heart and the heart can no longer pump
41
how do you decrease activity intolerance in patients with HF
avoid wasting energy perform regular activity (30-45 min/day) wait 2 hours after eating bedrest with acute exacerbation raise HOB and support arms avoid extreme weather
42
name 2 big parts of diet restriction for patient with HF
fluid restrictions and Na+ restriction (2000/day)
43
explain pulmonary edema
caused by acute even resulting in LV failure LV fails and blood backs up into pulmonary circulation
44
what is the overall result of pulmonary edema
hypoxia
45
explain the management of pulmonary edema
early recognition administer O2 diuretics vasodilators
46
list 4 things to assess for early recognition of pulmonary edema
frequent lung sound assessment decreased urine output increased edema decreased O2 sats
47
explain the relationship between cardiac output and perfusion during cardiogenic shock
a decrease in CO = a decrease in perfusion, leading to the initiation of shock
48
explain the 3 goals of cardiogenic shock management
correct the underlying cause of shock decrease preload & afterload = decrease the cardiac workload increase O2 to restore perfusion
49
what do we monitor during cardiogenic shock management
hemodynamics fluid status medications/med adjustments
50
what meds do we give for cardiogenic shock management
diuretics positive ionotropic agents vasopressors
51
what do positive ionotropic agents do
increase heart contractility
52
how do we provide circulatory assist during cardiogenic shock
placement of IABP (intra-aortic balloon pump)
53
what are the 2 treatments for pericardial effusion?
pericardiocentesis pericardiotomy
54
explain pericardiocentesis
puncture of the fluid sac in order to aspirate the excess fluid
55
explain pericardiotomy
removal of a portion of the pericardium to allow fluid to drain into the lymphatic system

NURS 201: Advanced Adult Health (28 decks)

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