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Medsurg Exam 2 > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

definition of heart failure

A

Inadequate cardiac output and oxygen delivery, caused by the inability of the heart to pump efficiently or to fill adequately

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2
Q

what is the most common medicare diagnosis and why

A

HF
age plays a role

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3
Q

what is ejection fraction

A

percentage of blood in the LV that makes it out of LV with each heartbeat

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4
Q

normal ejection fraction

A

60-70%

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5
Q

what is preload?

A

VOLUME of blood entering the heart

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6
Q

what is afterload?

A

RESISTANCE heart has to overcome to get blood out of the heart

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7
Q

what is contractility

A

force from heart muscle – how hard the heart can pump

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8
Q

purpose of inotropic medications

A

increase the contractility of the heart (digoxin, BB)

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9
Q

what is the cardiac output

A

amount of blood volume pumped per minute

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10
Q

what is stoke volume

A

amount of blood pumped out of the ventricle with each beat or contraction

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11
Q

how do you calculate cardiac output

A

CO = SV x HR

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12
Q

what does starling’s law say

A

-more volume = more stretched heart is the harder it can contract
-Decreased stroke volume and decreased CO begin compensatory mechanisms

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13
Q

compensatory mechanisms for decreased SV and CO

A

SNS activates
RAAS activates
B-type natriuretic peptide release
Structural changes occur

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14
Q

peptide released when ventricle is filled with too much fluid and stretches – tries to get body to diureis fluid

A

B-type natriuretic peptide

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15
Q

possible causes of heart failure

A

Uncontrolled HTN!!!
Recreational drug use
Infections of the heart
Valvular disorders
Arrhythmias (a fib, tachycardia)
Ischemia/Infarction (MI, CAD)
Congenital defects

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16
Q

causes of left sided HF

A

systemic causes

Coronary artery disease
Hypertension
Cardiomyopathy
Rheumatic heart disease

17
Q

causes of right sided HF

A

pulmonary causes

Chronic obstructive pulmonary disease (COPD)
Pulmonary embolus
Right heart failure due to pulmonary issues (termed “cor pulmonale”)
RV infarct

18
Q

classification of systolic HF

A

contraction

Majority of patients
Ventricle unable to contract and eject blood
Ejection fraction is decreased

19
Q

classification of diastolic HF

A

relaxation

Ventricle is stiff and can’t fill adequately – they cannot relax and let blood in
Usually related to long-standing hypertension or aortic stenosis

20
Q

clinical manifestations of right sided HF

A

rest of the body

Swelling, generalized edema
Weight gain
JVD
Hepatomegaly
Ascites
Irregular heat rate
Increased abdominal girth
Nocturia
Anorexia
N/V
Dependent edema
Fatigue

21
Q

clinical manifestations of left sided HF

A

back to the lungs

Dyspnea
Rales – crackles
Orthopnea
Fatigue
Cyanosis
Paroxysmal nocturnal dyspnea
Tachycardia
Nagging cough
Pulmonary edema – pink frothy sputum
S3 heart sound
Confusion/restlessness

22
Q

AHA/ACC HF stages A-D

A

A – Patient with risk factors but no left ventricular impairment
B – Asymptomatic with LV hypertrophy and/or impaired LV function
C – Current or past symptoms of heart failure
D – Refractory HF eligible for heart transplant, inotropic and/or mechanical support

23
Q

NYHA Functional Class 1-4

A

I – No symptoms with physical activity such as dyspnea or chest pain
II – Mild symptoms with ordinary activities
III – Marked limitation with physical activity but comfortable at rest
IV – Severe limitation and distress with physical activity or at rest

24
Q

normal range for BNP

A

less than 400

25
Q

Evaluates the EF and diastolic function
May distinguish systolic from diastolic dysfunction

A

echocardiography

26
Q

diagnostic tests for HF

A

stress test or coronary angiography (Evaluates for active or reversible ischemia)

two view chest x-ray (Evaluates chamber size and pulmonary congestion)

27
Q

why is an EKG not a useful screening tool

A

purely the pathway of electricity – not how hard the heart is pumping

28
Q

nursing assessments for pts with HF

A

Responsiveness to medications: monitor HR, BP, volume status
I&O, daily weights!!!
Compliance with diet and fluids
Respiratory status
Safety
Monitor vital signs (HR, BP)
S/S of decreased CO
Labs: K+, BUN, creatinine, Dig levels, BNP!!!, troponins

29
Q

what should the nurse educate the pt on with HF

A

Low sodium diet
Fluid restriction
Daily weights
Med compliance
Smoking cessation
Know the s/s of exacerbation
Vaccinations – illness –heart stress
Exercise
Limit alcohol intake

30
Q

medications to treat HF

A

ACE Inhibitors (-prils)
ARBs (-sartan)
Diuretics
Beta Blockers (-lols)
Vasodilators
Digoxin

31
Q

devices to treat HF

A

Pacemakers – stimulate heart to beat
Biventricular pacemakers
ICDs
Ventricular-assist device (VAD)

32
Q

where is the fluid buildup in pulmonary edema

A

fluid in interstitial spaces and the alveoli

33
Q

fluid accumulated around pleural space

A

pulmonary effusion

Medsurg Exam 2 (6 decks)

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