Final - CHF

Question 1

Risk Factors for CHF

Answer 1

• HTN
• valvular disease
• CAD

Question 2

Clinical mnfts of left sided heart failure

Answer 2

• dyspnea
• orthopenea
• paroxysmal nocturnal dyspnea
• cough
• fatigue
• pulmonary crackles
• decreased 02 saturation
• dysrhythmias

Question 3

Clinical mnfs of right sided heart failure

Answer 3

• jugular vein distention
• fluid retention
• dependent edema
• pleural effusion
• hepatomegaly
• ascites
• anorexia and nausea

Question 4

Diagnosing CHF

Answer 4

• medical imaging: Chest x-ray, echocardiogram

- lab: BNP

Question 5

what are the actions of brain natuertic peptides

Answer 5

-decrease in systemic vascular resistance and central venous pressure
-increase in natueresis
(process of excretion of sodium in the urine via action of the kidneys)

Question 6

pharmacological management of CHF

Answer 6

• ACE inhibitors
• Angiotensin receptor blockers (ARB)
• Beta blockers
• Diuretics
• Digoxin

Question 7

ACE inhibitors for CHF

Answer 7

ex. Ramapril
MOA: Ace inhibitors block the conversion of angiotensin 1 to angiotensin 2, thus creating peripheral resistance(vasodilation) and decreasing blood volume

Question 8

Angiotensin recpetor blockers for CHF

Answer 8

ex. Loastoran (candestaran)
MOA: blocks the effect of angiotenisn 2 receptor
similar effects to ACE1, decreased peripheral resistance (vasodilation) and blood volume.

Question 9

what are labs that you would want to monitor during treatment of CHF

Answer 9

-electrolytes,BUN, creatinine, GFR

Question 10

Beta Blockers for CHF

Answer 10

ex. Metoprolol

MOA: blocks stimulation of beta-adregnic receptors. Reduces sympathetic stimulation of the heart

Question 11

Digoxin for CHF

Answer 11

MOA: increases contractility or strength of cardiac contractions. Inhibits the enzyme responsible for sodium-potassium exchange which causes calcium release and production of a more forceful contraction

Question 12

precheck for digoxin

Answer 12

take apical pulse for 1 full minute noting rate and rhythm if less than 60 may hold digoxin

Question 13

Nursing managment for CHF

Question 14

Managing fluid volume important in CHF can be done by:

Answer 14

• Diuretic therapy
• daily weight
• respiratory assessment (for fluid in lungs)
• positioning to reduce preload
• assesing skin for breakdown

Question 15

pt may have activity intolerance and shortness of breath to CHF some nursing management techniques for this are

Answer 15

activity intolerance:

• rest
• individualizing period of daily exercise gradually increasing in duration

Shortness of Breath:

• supplemental 02 and monitor 02 stats
• raise head of bed
• resp assesment

Question 16

pt may have activity intolerance and shortness of breath to CHF some nursing management techniques for this are

Answer 16

activity intolerance:

• rest
• individualizing period of daily exercise gradually increasing in duration

Shortness of Breath:

• supplemental 02 and monitor 02 stats
• raise head of bed
• resp assessment

Question 17

diuretics for treatment of CHF

Answer 17

-diuretics are prescribed to remove excess extracellular fluid by increasing rate of urine produced by pts with signs and symptoms of fluid overload