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NCLEX > Heart Failure > Flashcards

Heart Failure Flashcards

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1
Q

Describe Frank Starling’s Law.

A

Pressure is proportional to SV.

increase EDV = increase PRELOAD = increase SV = increase CONTRACTILITY

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2
Q

Presentations of Left Heart Failure

A

[PERIPHERAL CONGESTION]

  • Peripheral edema (increase in abd. girth)
  • LOC, fatigue (ischemia)
  • Impaired liver fx (liver congestion)
  • End organ failure/anorexia, weight loss, GI distress (GI congestion)
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3
Q

Presentations of Right heart failure

A
  1. Decreased CO
    - Activity intolerance + Hypoxemia (low perfusion)
  2. Impaired gas exchange
    - Cyanosis/Hypoxia (impaired gas exchange)
  3. Pulmonary edema
    - Orthopnea
    - Paroxysmal nocturnal dyspnea
    - Wet cough
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4
Q

What is orthopnea?

A

Breathlessness when laying down.

- Sx: LS heart failure

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5
Q

Paroxysmal nocturnal dyspnea

A

SOB that awakens a person

- Sx: LS heart failure

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6
Q

Inotropy

A

Medications that alter heart’s contractility

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7
Q

What is the focus of tx for HF?

A
  1. Decrease cardiac workload + increase O2 supply

2. Increase contractility

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8
Q

Cardiac Glycosides

  • MOA? (2)
  • Tx for _____?
  • Common medications
  • Contraindications?
A

MOA: Affects overall electrolyte transport across cell membrane

  1. Blocks NA/ATPase = high NA-Ca exchange in cell = increased contractility
  2. Slow electrical conduction @ AV node = lowers HR + increases CO

Tx:

  • Chronic HF
  • Arrhythmias

Common drugs:
- Digoxin (Lanoxin), Digitoxin

Contraindications:

  • Apical pulse for 1 min <60bpm = HOLD
  • Antidote for toxicity: DIGIBIND (1st sign is N+V)
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9
Q

Digitalization

A

The loading dose of cardiac glycosides

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10
Q

P-Inhibitors

  • MOA?
  • Tx for ____?
A

Block phosphodiesterase (PDE) = increases cAMP

  • Increases contractility of myocardial cells
  • Vasodilation/relaxation of smooth muscle cells

Tx: Acute HF

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11
Q

What drug class does Viagra belong to?

A

P-Inhibitor

- Increase BF to genitals = erection

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12
Q

Milrinone, Amrinone
Drug class?
What is it used to treat?

A

P-Inhibitors

Tx: Acute HF

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13
Q

Adrenergic Agonists

  • What is the MOA?
  • Tx for _____?
A

MOA (mimic catecholamines)

  1. Increases contractility
  2. Increases CO
  3. Vasodilation

Tx: Acute HF

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14
Q 
What drug class does "Dobutamine" belong to?
- Tx for \_\_\_\_\_\_?
A

Adrenergic Agonists: direct sympathomimetic (beta-1 specific)

Tx: Acute HF

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15
Q 
What drug class does "Dopamine HCL" belong to?
- Tx for \_\_\_\_\_\_?
A

Adrenergic Agonists: non-selective beta (precursor to Norepi)

Tx: Acute HF

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16
Q

What meds are used to tx Acute Heart Failure?

A
  1. Loop diuretics = decrease preload
  2. Direct Acting Vasodilators or NO = dilate
  3. B1 Agonists = increase contractility
  4. P-inhibitors = increase contractility in heart cell + vasodilation in smooth muscle cell
17
Q

What meds are used to tx Chronic Heart Failure?

A
  1. Cardiac glycosides > B1 agonists

2. ACE, ARBs > NO

18
Q

Arrhythmia

  • Different stimuli (3)
  • Tx
A

Problem with rate/rhythm of heartbeat.

Stimuli:

  • Re-entry circuits to SA node (Afib, SVT)
  • AV node dfx
  • PNS stimulation (vagal nerve)

Tx:

  1. Decrease SA-AV node conduction
    - Digoxin
    - ITN: Ablation (long term; low efficacy)
  2. Depress ectopy @ ventricular level
    - alters cell fx
  3. Enhance normal AV conduction
    - Meds are block ion transport (Na, K)
19
Q 
Supraventricular tachycardia (SVT) 
- Describe txs
A

A group of abnormally rapid heartbeats that starts in the atrias.

Tx
1. CARDIOAVERSION: interrupts ventricle depolarization through low voltage

  1. ADENOSINE: inhibits cerebral synapse @ adenosine receptors
    * *Sedative, but shares same receptor as caffeine!
  2. ANTIARRHYTHMICS (Digoxin, Lidocaine, Amiodarone)
20
Q

Lidocaine

A

Anti-arrhythmic - Enhances normal AV conduction by blocking Na-channel

21
Q

Amiodarone

A

Anti-arrhythmic - Enhances normal AV conduction by blocking K-channel

22
Q

Atrial fibrillation

A

Irregular heartbeats and rapid arrhythmia that can lead to blood clots.
- Caused by CAD, etc.

23
Q

Sinus rhythm

A

The rhythm of your heart beat, determined by the sinus node of your heart.

24
Q

What classes of medications are used to treat HF?

A
  1. Anti-hypertensives (Diurectics, ACE/ARBs, AA, NO, CCB)
  2. Cardiac glycosides
  3. P-inhibitors
  4. Adrenergic Agonists

NCLEX (19 decks)

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