Heart Failure

Question 1

systolic heart failure

Answer 1

inability to pump blood forward (heart can’t contract and eject blood)

Question 2

diastolic heart failure

Answer 2

inability of the ventricles to relax and fill during diastole

Question 3

ejection fraction is . . .

Answer 3

a measurement of the percentage of blood leaving the heart each time it squeezes

Question 4

a low ejection fraction would mean. . .

Answer 4

possible heart failure

Question 5

preload

Answer 5

volume of blood in the ventricles at the end of diastole (end diastolic pressure)

Question 6

afterload

Answer 6

resistance the left ventricle must overcome to circulate blood

Question 7

what conditions increase preload

Answer 7

• hypervolemia
• heart failure
• regurgitation of cardiac valves

Question 8

what condition increase afterload

Answer 8

• hypertension
• vasoconstriction

increased afterload = increased cardiac workload

Question 9

what are the primary risk factors for heart failure

Answer 9

• hypertension
• African American
• CAD

Question 10

rationales for s1

Answer 10

tricuspid and mitral (bicuspid) valves closing (lub)

Question 11

rationales for s2

Answer 11

pulmonic and aortic valves closing (dub)

Question 12

rationales for s3

Answer 12

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

Question 13

rationales for s4

Answer 13

late diastolic filling of the ventricle d/t atrial contraction

Question 14

what two ways can heart valves dysfunction?

Answer 14

• regurgitation (valve doesn’t close all the way)
• stenosis (valve doesn’t open all the way)

Question 15

signs of decreased cardiac output

Question 16

major complication of heart valve dysfunction

Question 17

lifespan of a mechanical heart valve

Answer 17

20-25 years

Question 18

nursing considerations for mechanical heart valve

Question 19

lifespan of a tissue heart valve

Answer 19

15 years

Question 20

nursing considerations for a tissue heart valve

Question 21

signs and symptoms of left sided heart failure and WHY they’re happening

Answer 21

• 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

Question 22

interventions for left sided heart failure

Question 23

signs and symptoms of right sided heart failure and WHY they’re happening

Answer 23

• 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

Question 24

interventions for right sided heart failure

Answer 24

• 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)

Question 25

BNP normal range

Answer 25

0-100

Question 26

what does an abnormal BNP value mean?

Answer 26

stretching of heart muscle (too much fluid)

Question 27

PT normal range

Answer 27

10-14 seconds

Question 28

wanted PT range

Question 29

medication that correlates to PT

Question 30

what does an echocardiogram look for?

Question 31

what does an abnormal echocardiogram mean?

Question 32

what should be restricted in a CHF client’s diet?

Answer 32

sodium (2g/day)

Question 33

what are the contributory risk factors for heart failure?

Answer 33

• advanced age
• diabetes
• tobacco
• obesity
• high cholesterol