Heart Failure Flashcards

1
Q

What are the typical causes of left sided HF?

A

htn, CAD, valvular disease

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2
Q

s/s of left sided HF

A

paroxysmal nocturnal dyspnea
orthopnea
crackles
wheezes
restlessness
exertional dyspnea
oliguria

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3
Q

what are the subtypes of left sided HF?

A

systolic and diastolic

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4
Q

what is systolic HF?

A

heart cannot contract forcefully enough during systole to eject adequate amounts of blood into circulation
ejection fraction is less than 35%

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5
Q

what is ejection fraction?

A

percentage of blood ejected from heart during systole

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6
Q

what is a normal ejection fraction?

A

50-70%

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7
Q

What types of patients are candidates for an ICD?

A

pts with an ejection fracture less than 30%

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8
Q

What is diastolic HF?

A

HF with preserved left ventricular function
left ventricle cannot relax causing inadequate filling
ventricle has to work harder

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9
Q

What is Right sided HF?

A

right ventricle cannot empty properly
increased volume and pressure cause edema
i.e. pulmonary hypertension

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10
Q

clinical manifestations of right sided HF?

A

JVD
hepatomegaly
anorexia and GI distress
ascites
dependent edema
polyuria

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11
Q

what is high output HF?

A

cardiac output remains normal or above normal

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12
Q

what causes high output HF?

A

increased metabolic needs
septicemia
high fever
anemia
hyperthyroidism

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13
Q

What is BNP what does it test for?

A

produced and released by the ventricles as they stretch in response to fluid overload
how much fluid you are retaining

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14
Q

what is the BNP for no HF?

A

100 or less

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15
Q

BNP for mild HF

A

100-300

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16
Q

BNP for moderate HF

17
Q

BNP for severe HF

A

700 or more

18
Q

Risk factors for HF

A

smoking
obesity
family hx
HTN
drugs
valvular disease
DM
sleep apnea

19
Q

what is pulse alternans?

A

a weak pulse alternates with a strong pulse despite a regular heart rhythm

20
Q

What is stage A of HF?

A

people who are high risk

21
Q

What is Stage B HF?

A

Structural heart disease but no s/s

22
Q

What is stage C of HF?

A

Heart disease with signs of HF

23
Q

What is stage D of HF?

A

end stage heart failure
ICD is used until person can get a transplant

24
Q

What does Digoxin do?

A

Increase contractility
reduces HR
slows conduction thru AV node

25
What are the s/s of Digoxin toxicity?
fatigue dysrhythmias PVCs Anorexia
26
What must you monitor when giving digoxin and why?
potassium bc hypokalemia can cause digoxin toxicity
27
What is dobutamine?
beta blocker that increases contractility and and CO/perfusion
28
difference between metoprolol tartrate and succinate?
Succinate is an XR Tartrate is short acting
29
what is cardiac resynchronized therapy?
uses a permanent pacemaker or combined with an implantable cardioverter/defibrillator stimulates more synchronized ventricular contractions
30
Ventricular Assist Device
directly assist the heart's pumping
31
what is a worse complication of HF?
pulmonary edema
32
s/s of pulmonary edema
crackles ALOC tachycardia reduced urinary output cough with frothy, pink tinged sputum cold, clammy skin
33
Emergency interventions for pulmonary edema?
Position in high fowlers give 100% oxygen establish IV access Give IV NTG lasix 40-80 mg Morphine 2-5 mg
34
How fast can lasix be pushed?
1- 2 minutes to prevent ototoxicity
35
why is morphine administered for pulmonary edema?
to reduce preload and decrease any anxiety and work of breathing
36
what is the patient education for HF? (Remember MAWDS)
avoid NSAIDS medication compliance stay active at your limit dont overdo it daily weighing at the same time w/ same scale limit fluid intake to 2L sodium to 2-3g
37
what are the s/s of worsening HF?
rapid weight gain 2-3 lbs overnight decrease in exercise tolerance lasting 2-3 days cough/ cold symptoms lasting more than 3-5 days polyuria at night increased angina or dyspnea increased edema in feet, ankles, and hands
38
Why do we give patients with HF ACEI?
ACE inhibitors cause arterial dilation and increased stroke volume and helps get rid of extra fluid