heart failure

Question 1

when does heart failure occur

Answer 1

Heart failure occurs when the heart muscle is unable to pump effectively
- Myocardial hypertrophy
- Pulmonary/systemic congestion.

Question 2

Result of an acute or chronic cardiopulmonary problem

Answer 2

Systemic hypertension
Myocardial infarction (MI)
Pulmonary hypertension
Dysrhythmias
Valvular heart disease
Pericarditis
Cardiomyopathy

Question 3

heart failure class

Answer 3

class 1-4

Question 4

class 1

Answer 4

Client exhibits no symptoms with activity.

Question 5

class 2

Answer 5

Client has symptoms with ordinary exertion

Question 6

class 3

Answer 6

Client displays symptoms with minimal exertion

Question 7

class 4

Answer 7

Client has symptoms at rest

Question 8

left sided heart failure

Answer 8

** not connected to lungs but more resp issues, backs into lungs***
- Dyspnea, orthopnea (shortness of breath while lying down), nocturnal dyspnea
- Fatigue
- Displaced apical pulse (hypertrophy)
- S3 heart sound (gallop)
- Pulmonary congestion (dyspnea, cough, bibasilar crackles)
- Frothy sputum (can be blood-tinged), pink tinged
- Altered mental status
- Manifestations of organ failure, such as oliguria (decrease in urine output)

Question 9

right sided heart failure

Answer 9

*connected to veins
- Jugular vein distention
- Ascending dependent edema (legs, ankles, sacrum) check lbs daily
- Abdominal distention, ascites
- Fatigue, weakness
- Nausea and anorexia
- Polyuria at rest (nocturnal)
- Liver enlargement (hepatomegaly) and tenderness
- Weight gain

Question 10

cardiomyopathy s/s

Answer 10

• Fatigue, weakness
• Heart failure (left with dilated type, right with restrictive type)
• Dysrhythmias (heart block)
• S3 gallop
• S4 heart sound (extra fluid when ventricles filling)
• Cardiomegaly (enlarged heart), more severe with dilated type
• Angina (hypertrophic type)

Question 11

diagnostic procedures

Answer 11

• Hemodynamic monitoring
• Ultrasound
• Transesophageal echocardiography (TEE)
  Uses a transducer placed in the esophagus behind the heart to obtain a detailed view of cardiac structures. The nurse prepares the client for a TEE in the same manner as for an upper endoscopy
• Chest Xray
• ECG, cardiac enzymes, electrolytes, and ABGs

Question 12

nursing care for heart failure

Answer 12

• Monitor daily weight and I&O.
• Assess for shortness of breath and dyspnea on exertion.
• Administer oxygen as prescribed.
• Monitor vital signs and hemodynamic pressures.
• Position the client to maximize ventilation (high-Fowler’s).
• Check ABGs, electrolytes (especially potassium if on diuretics), SaO2, and chest x-ray findings.
• Assess for signs of medication toxicity (digoxin toxicity).
• Encourage bed rest until the client is stable.
• Encourage energy conservation by assisting with care and ADLs.
• Maintain dietary restrictions as prescribed (restricted fluid intake, restricted sodium intake)
• avoid nsaid: promote bleeding, raise NA in kidney: give tyanol instead

Question 13

herbals

Answer 13

• Herbal medications can stimulate the cardiovascular system.
• Obtain a list of herbal supplements the client takes, and advise the client of potential contraindications

Question 14

diuretics used for

Answer 14

used to decrease preload

Question 15

loop diuretics

Answer 15

Furosemide
Bumetanide

Question 16

thiazide diruetics

Answer 16

Hydrochlorothiazide
- manage bp

Question 17

potassium sparing

Answer 17

Spironolactone
- watch K+

Question 18

diuretics nursing considerations

Answer 18

• Administer furosemide IV no faster than 20 mg/min.
• Loop and thiazide diuretics can cause hypokalemia, and potassium supplementation can be required.
• Teach clients taking loop or thiazide diuretics to ingest foods and drinks that are high in potassium to counter the effects of hypokalemia.

Question 19

procedures

Answer 19

Ventricular assist device (VAD)
Heart transplantation

Question 20

complications from procedures

Answer 20

Cardiogenic Shock
Cardiac Tamponade
Acute Pulmonary Edema