Heart Failure Flashcards
Exam 2
Heart Failure Epidemiology
6.5 million people over age 20
1 million new cases each year
Heart failure is based on what?
Based on the ejection fraction
What is the normal ejection fraction of a normal healthy adult?
Anywhere between 55-70%
What would the ejection fraction be of someone who is in heart failure?
As low as 20%
What is it called when we have heart failure on both sides of the heart?
Biventricular Heart Failure
What is right sided heart failure?
The inability of the right side of the heart to effectively piump blood to the lungs.
What left sided heart failure?
The inability of the left side of the heart to effectively pump blood to the rest of the body
Acute heart failure
Something that is sudden; needs to be treated right away.
Chronic Heart Failure
Patient had heart failure for a while
The body has the ability to kind of compensate for that.
What is a tell tale sign of heart failure?
Weight gaining is a tell tale sign of an exacerbation.
What is an important thing to monitor is heart failure patients?
Weight
Check weight daily
Heart Failure Risk Factors
C A D,
hypertension,
D M,
metabolic syndrome,
obesity,
smoking,
high sodium intake
African descent
Age- greater than 65
Men greater risk than women
Heart Failure: Pathophysiology
Myocardial cell dysfunction
Inability of heart to meet needs of body
Heart Failure: Clinical Manifestations
Fatigue
Weight gain
Tachycardia
Hypo or hypertension
Murmurs
Heart Failure: Medical Management - Diagnosis
Physical assessment
Chest x-ray
Echocardiogram
ECG
Multigated acquisition scans
Laboratory testing
Heart Failure: Medical Management
Treatment
Reduction of risk factors
Manipulation of cardiac output
Heart Failure- Medical Management- Medications
Beta blockers
Aldosterone antagonist diuretics
A C E inhibitors
Calcium channel blockers
Digoxin
If patient is given digoxin, what needs to be checked?
HR
Heart Failure: Surgical Management
Internal cardiac defibrillator
Ventricular assist device
What may patients be given to treat heart failure? Why?
Nitroglycerin or vasodilators
Open up the blood vessels
Heart Failure- Self-Management
Symptom monitoring
Medication adherence
Lifestyle changes
Heart Failure- Complications
Pulmonary edema
Renal failure
Heart Failure: Nursing Management- Assessment and Analysis
Signs and symptoms related to weakened cardiac contraction, decreased cardiac output, back up of blood, poor peripheral perfusion
Heart Failure: Nursing Diagnoses
Impaired oxygenation
Decreased cardiac output
Ineffective peripheral perfusion
Heart Failure: Nursing Interventions – Assessments
Vital signs
Breath sounds
Monitor rate and rhythm
Skin color, temperature, peripheral pulses
Dry, persistent cough
Activity intolerance
Urine output
Daily weight
Laboratory data
Depression screening
Social support
Heart Failure: Nursing Interventions- Actions
Oxygen therapy
Elevate head of bed
Administer medication as ordered
Fluid and sodium restriction
Heart Failure: Teaching
Medication management
Maintain activity as tolerated
Low-salt diet
Daily weight
Cardiac rehabilitation
Signs and symptoms of worsening heart failure
Heart Failure: Evaluating Care Outcomes
Reduced dyspnea
Absence of fatigue
Participates in activities of daily living
Reduced hospitalizations
Hypertension: Epidemiology
78 million people in the U S
Hypertension: Risk Factors
Race
Gender
Socioeconomic status
Hypertension: Clinical Manifestations
Headaches
Chest pain
Vision changes
Shortness of breath
Renal dysfunction
Dizziness
Fatigue
Nosebleeds
Hypertension:
Medical Management- Diagnosis
Two or more bp readings on >2 office visits
Hypertension: Treatment
Lifestyle changes
Medications
Hypertension: Medications
Diuretics
Antihypertensives
Hypertension:
Lifestyle Management
Weight
Diet
Alcohol consumption
Exercise
Stress
Hypertension: Complications
Dilated cardiomyopathy
Systolic dysfunction
Renal failure
Stroke
Hypertensive crisis
Hypertension: Nursing Management- Assessment and analysis
Typically no symptoms until disease is advanced
Hypertension: Nursing diagnoses
Risk for ineffective therapeutic regimen management
Risk for decreased cardiac output
Hypertension: Nursing Interventions – Assessments
Neurological assessment
Blood pressure
Examination of optic fundi
Auscultation for bruits
Palpation for edema and pulses
Labs
B M I and waist circumference
Hypertension: Nursing Interventions – Actions
Administer medications as ordered
Provide DASH diet
DASH diet
1,600 mg sodium restriction
Hypertension: Teaching
Adherence to medication regimen
Adherence to lifestyle changes
Monitor blood pressure at home
Signs and symptoms of complications
Hypertension: Nursing Management – Evaluating care outcomes
Increased energy
Absence of energy, headache, dizziness, vision changes
Myocardial Infarction Epidemiology
630,000 deaths per year
One in four deaths
Myocardial Infarction: Risk Factors
Smoking
High L D L
Type 2 diabetes
Elevated adrenaline
Obesity
Inactivity
Hypertension
Myocardial Infarction: Non-modifiable Risk Factors
Male sex
Post menopausal women
Family History
Myocardial Infarction: Clinical Manifestations
Chest pain
Shoulder and arm pain
`
Myocardial Infarction: Medical Management-Diagnosis
Laboratory tests (troponin, etc)
Diagnostic testing
Myocardial Infarction: Medical Management- Treatment
Maximize oxygenation
Control pain
Dilate coronary arteries
Prevent clots
Decrease myocardial workload
Myocardial Infarction: Medical Management- Medications
Oxygen
Nitroglycerin
Aspirin
Pain medication
Myocardial Infarction: Surgical Management
Coronary artery bypass graft
Myocardial Infarction: Complications
Heart failure
Arrhythmias
Myocardial Infarction: Nursing Management- Assessment and analysis
Signs/symptoms related to lack of oxygen delivery
Myocardial Infarction- Nursing Management – Nursing diagnoses
Decreased cardiac output
Pain
Myocardial Infarction: Nursing Interventions – Assessments
Vital signs and pulse oximetry
Characteristics of pain
E C G
Restlessness
Skin color and temperature, peripheral pulses, diaphoresis
Urine output
Labs
Myocardial Infarction: Nursing Interventions – Assessments Post-CABG
HR and BP
Hemodynamic monitoring
Continuous cardiac monitoring
Heart tones
Breath sounds and continuous oxygen saturation
Core temperature
Myocardial Infarction: Nursing Interventions – Actions
Administer oxygen
Insert two large-bore IVs
Administer medications as ordered
Continuous E C G monitoring
Bed rest
