Heart Failure Flashcards
systolic heart failure
inability to pump blood forward (heart can’t contract and eject blood)
diastolic heart failure
inability of the ventricles to relax and fill during diastole
ejection fraction is . . .
a measurement of the percentage of blood leaving the heart each time it squeezes
a low ejection fraction would mean. . .
possible heart failure
preload
volume of blood in the ventricles at the end of diastole (end diastolic pressure)
afterload
resistance the left ventricle must overcome to circulate blood
what conditions increase preload
- hypervolemia
- heart failure
- regurgitation of cardiac valves
what condition increase afterload
- hypertension
- vasoconstriction
increased afterload = increased cardiac workload
what are the primary risk factors for heart failure
- hypertension
- African American
- CAD
rationales for s1
tricuspid and mitral (bicuspid) valves closing (lub)
rationales for s2
pulmonic and aortic valves closing (dub)
rationales for s3
brief vibration in early diastole at the end of rapid diastolic filling period of the right or left ventricle
- left sided HF
- mitral regurgitation
- low ejection fraction
rationales for s4
late diastolic filling of the ventricle d/t atrial contraction
what two ways can heart valves dysfunction?
- regurgitation (valve doesn’t close all the way)
- stenosis (valve doesn’t open all the way)
signs of decreased cardiac output
major complication of heart valve dysfunction
lifespan of a mechanical heart valve
20-25 years
nursing considerations for mechanical heart valve
lifespan of a tissue heart valve
15 years
nursing considerations for a tissue heart valve
signs and symptoms of left sided heart failure and WHY they’re happening
- restlessness/confusion
- paroxysmal nocturnal dyspnea (lungs do not expand well when lying down. fluid pools in alveoli, client becomes dyspneic)
- orthopnea
- exertional dyspnea
- cyanosis
- pulmonary congestion (cough, wheezing, blood-tinged sputum, tachypnea)
- elevated pulmonary capillary wedge pressure
interventions for left sided heart failure
signs and symptoms of right sided heart failure and WHY they’re happening
- anorexia (GI organs are compressed d/t FVE in the abdominal cavity, the liver and spleen enlarge)
- oliguria (low urine output, pt is retaining fluid-urine output will decline as 3rd spacing increases)
- ascites
- enlarged liver/spleen
- distended jugular veins
- dependent edema
interventions for right sided heart failure
- offer smaller more frequent meals, avoid constipation, decrease Na in diet to decrease fluid retention, diuretics to pull fluid from 3rd space (anorexia)
- diuretics to pull fluid out of 3rd space, fluid restrictions, lower Na intake, monitor I/O (oliguria)
BNP normal range
0-100
what does an abnormal BNP value mean?
stretching of heart muscle (too much fluid)
PT normal range
10-14 seconds
wanted PT range
medication that correlates to PT
what does an echocardiogram look for?
what does an abnormal echocardiogram mean?
what should be restricted in a CHF client’s diet?
sodium (2g/day)
what are the contributory risk factors for heart failure?
- advanced age
- diabetes
- tobacco
- obesity
- high cholesterol
