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NUR 326 Exam 3 > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Cardiomyopathy: Definition

A

disease that affect the myocardium
LEADS TO HEART FAILURE

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2
Q

Cardiomyopathy: Causes (8)

A

usually idiopathic
ischemia
HTN
inherited disorders
infections
toxins
myocarditis
auto-immune condition

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3
Q

Cardiomyopathy: Types (3)

A
  1. dilated cardiomyopathy
  2. hypertrophic cardiomyopathy
  3. restrictive cardiomyopathy (amyloid)
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4
Q

Heart Failure (HF): Definition

A

A chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen
–> basically, the heart can’t keep up with its workload

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5
Q

HF: Some Patho

A

myocardium is weakened—> pump is insufficient to pump blood forward and can’t meet the body’s demands

*MOST common cause oof hospitalization

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6
Q

Cardiac Output is?

A

decreased with HF

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7
Q

Factors determining Cardiac Output (2)

A

heart rate
stroke volume

*Cardiac Output= stroke volume x heart rate

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8
Q

Factors that Affect Stroke Volume (3)

A
  1. preload (amount of volume in left ventricle before it squeezes)
  2. afterload (the pressure the heart has to squeeze against when it contracts)
  3. myocardial contractility (pump muscle)
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9
Q

HF results in? (4)

A
  1. decreased cardiac output
  2. decreased myocardial contractility
  3. increased preload
  4. increased afterload
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10
Q

HF: Development (Patho Changes)

A

volume OVERLOAD–> IMPAIRED ventricular filling–> WEAKENED ventricular muscle–> DECREASED ventricular contractile function

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11
Q

When does the heart fill?

A

diastole

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12
Q

When does the heart contract?

A

systole

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13
Q

HF: Etiology: MAJOR Causes (7)

A

-REPEATED ISCHEMIC EPISODES- ischemic cardiomyopathy
-myocardial infarction– papillary muscle rupture
-chronic HTN
-COPD (RVF)
-Dysrhythmias
-Valve disorders; mitral insufficiency, aortic stenosis
-pulmonary embolus (RVF)

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14
Q

HF: MAJOR Risk Factors (9)

A

-age (increases with age, most common reason for hospitalization in ages >65)
-ethnicity (Black/African Americans are at a higher risk than Caucasians)
-family history and genetics
-diabetes
-ischemic heart disease
-obesity
-HTN
-smoking
-sedentary lifestyle

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15
Q

HF: Other Risk Factors (8)

A

-within 6 months of MI
-22% men
-46% women
-men and postmenopausal women have same risk
-COPD
-severe anemia
-congenital heart defects
-viruses (certain viral infections can cause myocarditis)
-alcohol abuse/drug abuse
-kidney conditions
-excess blood volume,
edema, and
accumulation of
nitrogenous waste
(weakens the heart)

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16
Q

Which is considered the GREATEST risk factor for HF?

A

HTN
Diabetes can also contribute

17
Q

What hormone is cardioprotective?

A

estrogen
believed to be why men are typically more common for HF in younger ages until women are post-menopause

18
Q

HF: Classifications (2)

A

left sided vs. right sided

19
Q

Left sided HF: Characteristics (4)

A

-congestion in LEFT chambers
-LV increases in size (LVH)
-backflow into PULMONARY VEINS
-congestion in LUNGS

*LEFT=LUNGS

20
Q

Left sided HF: Symptoms (10)

A

cough
crackles
wheezes
frothy sputum (may be blood tinged)
paroxysmal nocturnal dyspnea (PND)
orthopnea
restlessness
confusion
tachycardia
fatigue

21
Q

Right sided HF: Characteristics (5)

A

-congestion in RIGHT chambers
-RV increases in size (RVH)
-backflow into VENA CAVA, decreased to the lungs
-congestion in JUGULAR VEINS, LIVER, LOWER extremities

*RIGHT=BODY

22
Q

Right sided HF: Symptoms (9)

A

jugular vein distention (JVD)
dependent edema
weight gain
hepatosplenomegaly
fatigue
ascites
anorexia
GI distress
increased peripheral venous pressure

23
Q

What is the MOST common cause of LEFT sided HF?

A

poorly controlled HTN

24
Q

What is the MOST common cause of RIGHT sided HF?

A

COPD

25
Q

HF: Reduced Ejection Fraction (HFrEF) (Systolic HF): Definition

A

Determined by patient’s EF: EF < 40%

26
Q

HF: Reduced Ejection Fraction (HFrEF) (Systolic HF): Caused by (4)

A

IMPAIRED contractile function
increased afterload
cardiomyopathy
mechanical problems

27
Q

HF: Reduced Ejection Fraction (HFrEF) (Systolic HF): Patho

A

left ventricle loses ability to generate pressure to eject blood–> weakened muscle cannot generate stroke volume and then lowers CO–> LV fails, blood backs up, and causes fluid backup and accumulation

28
Q

HF: Preserved Ejection Fraction (HFpEF) (Diastolic HF): Definition

A

inability of the ventricles to relax and fill during diastole

EF is normal or only moderately decreased (40-49%)

29
Q

HF: Preserved Ejection Fraction (HFpEF) (Diastolic HF): Cause/Risk Factors (4)

A

HTN is the primary cause

female
older age
diabetes
obesity

30
Q

HF: Preserved Ejection Fraction (HFpEF) (Diastolic HF): Patho

A

LV is stiff and noncompliant leading to high filling pressures–> leads to decreased stroke volume and decreased cardiac output–> reduced CO leads to fluid congestion

31
Q

Chronic vs. Acute HF

A

progressive
chronic
+ episodes of “decompensated” HF
-new or worsening s/s
-frequent visits to the ER
-hospitalization
-less common- new
onset HF (20%)

32
Q

Ventricular Remodeling in HF

A

a weakened heart muscle
-secretion of molecular
substances
-angiotensin II,
aldosterone, endothelin,
TNF-alpha,
catecholamines, insulin-
like growth factor, and
growth hormone
-provoke genetic
changes, apoptosis, and
hypertrophy of cardiac
myocytes, as well as
collagen deposits and
myocardial fibrosis
these molecules cause changes lead to ENLARGEMENT AND DILATION OF THE LEFT VENTRICLE
-WORSENS HF

33
Q

What murmur is common in HF?

A

S3 Gallop

34
Q

S3 Gallop

A

-low-pitched sound heard after S2
-during rapid filling of ventricle in the early part of diastole
-high ventricular end-diastolic volume
-increased pressure w/in ventricles

35
Q

S3 is abnormal and indicative of HF in adults of what age?

A

older than 40

NUR 326 Exam 3 (11 decks)

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