Heart Failure Flashcards
Heart failure is not a disease but a
complex clinical syndrome
Systolic HF has a _____ LV ejection fraction
decreased
Diastolic HF has a ______ejection fraction
preserved
The primary risk factors for HF is
HTN & CAD
____ HF has an inability to pump blood forward
Systolic
Systolic HF is caused by
impaired contractile function
Increased afterload
cardiomyopathy
mechanical abnormalities
Normal EF should be over ____% if pt. doesn’t have HF
60
In HF blood backs up and causes
Pulmonary congestion
QRS causes the ____ to pump
LV
Mixed systolic and diastolic HF patients need
an ICP pace maker because they have so many PVC which can slip into v-tach
Left sides HF is the most common form of HF. It results from
empty adequately during systole
fill adequately during diastole
L-sided HF blood backs up into teh LA and Pul. veins and this causes
Increased pulmonary pressures which cause fluids leakage –> pulmonary congestion (crackles) and pulmonary edema
Heart failure cause fluid to be in the lungs. It causes the left ventricle to be ____
enlarged
Right sided HF can be caused by
left-sided HF, cor pulmonale, right ventricular, MI
Backup of blood into the RIGHT atrium and venous systemic circulation
Right-sided HF
s/s of R-sided HF
jugular venous distension hepatomegaly (enlarged liver) splenomegaly (enlarged spleen) GI (N+V) Ascites Pain Dependent Peripheral edema (got to go to ER) Sudden weight gain (got to ER)
A patient with JVD needs to
sit at 90 degrees to breath
need to be at 45 degrees to see the JVD for assessment
HF compensatory mechanism
neurohotmal respones
ventricular dilation
ventirular hyperthrophy
20% of cardio output goes to the ____
25% of Co goes to the ____
kidneys
brain
No CO to kidneys cause
fluid retainsion
Enlargement of the chambers of the heart that occurs when pressure in the LV is elevated
Ventricular remodeling
____ medication is used to protect against ventricular remodeling
Lisinopril (ACE inhitbor)
S/s of HF
- sob
- fatigue
s/s of fluid overload
- pulmonary edema
- JVD
- ascites
- peripheral edema
as soon as CO drops the
resies actives
fluid retenion
HF will cause heart remodeling which affects the _____
Ventriculars first
NEVER bolus any ____ because it will stop the heart
electroylyes
The nurse is going to give potassium chloride. The nurse should
Get an IV pump
monitor urine output
monitor the VI site for infltration or phlebitis
ensure the med is diluted in the correct volume of fluid
ensure that the bag is labeled
If potassium is burning in the IV the nurse should
slwo the IV rate down
The most common type of HF is
Systolic HF
what HF are caused by metabolic problems?
Systolic and diastolic
what HF are caused by metabolic problems?
Systolic and diastolic
The diagnosis of HF is primarily made based on
Symptoms
What is the most definitive lab work for HF?
BNP
dobutamine is a
vasoconstrictor
What is the priority assessment by a nurse caring for a patient about to get dobutamine
blood pressure
A patient has JDV, peripheral edema what HF is this
Right sided
When patient has a low EF can they get digoxin?
no
a patient with HF taking furosemide. The medication is affected when
It reduces preload
s/s of pulmonary edema
severe dyspnea and blood streaked frothy sputum
A patient with acute HF what position do u put the pt in?
Sitting postion with arms overbed table
What does dopamine help with for a patient w HF
will tx: hypotension and tachycardia
Coumadin helps by
prevent binglood clots from forming in the hear
The patient is on coumadin you should check what lab?
INR
A patient on coumadin the INR should be
2-3
What drug can not be taken w nitro
avoid any erectile dysfunction drugs
ACE/ARB can cause
dizziness (hypotension)
angioedema
What medication decreases preload and afterload?
- nitro
- propranolol
- morphine
- captopril
Nitroglycerin
what does a betablocker do
lower HR and BP
