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Medsurg > Heart Failure > Flashcards

Heart Failure Flashcards

Exam 2

1
Q

Heart Failure Epidemiology

A

6.5 million people over age 20

1 million new cases each year

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2
Q

Heart failure is based on what?

A

Based on the ejection fraction

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3
Q

What is the normal ejection fraction of a normal healthy adult?

A

Anywhere between 55-70%

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4
Q

What would the ejection fraction be of someone who is in heart failure?

A

As low as 20%

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5
Q

What is it called when we have heart failure on both sides of the heart?

A

Biventricular Heart Failure

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6
Q

What is right sided heart failure?

A

The inability of the right side of the heart to effectively piump blood to the lungs.

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7
Q

What left sided heart failure?

A

The inability of the left side of the heart to effectively pump blood to the rest of the body

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8
Q

Acute heart failure

A

Something that is sudden; needs to be treated right away.

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9
Q

Chronic Heart Failure

A

Patient had heart failure for a while

The body has the ability to kind of compensate for that.

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10
Q

What is a tell tale sign of heart failure?

A

Weight gaining is a tell tale sign of an exacerbation.

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11
Q

What is an important thing to monitor is heart failure patients?

A

Weight

Check weight daily

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12
Q

Heart Failure Risk Factors

A

C A D,

hypertension,

D M,

metabolic syndrome,

obesity,

smoking,

high sodium intake

African descent

Age- greater than 65

Men greater risk than women

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13
Q

Heart Failure: Pathophysiology

A

Myocardial cell dysfunction

Inability of heart to meet needs of body

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14
Q

Heart Failure: Clinical Manifestations

A

Fatigue
Weight gain
Tachycardia
Hypo or hypertension
Murmurs

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15
Q

Heart Failure: Medical Management - Diagnosis

A

Physical assessment
Chest x-ray
Echocardiogram
ECG
Multigated acquisition scans
Laboratory testing

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16
Q

Heart Failure: Medical Management

Treatment

A

Reduction of risk factors
Manipulation of cardiac output

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17
Q

Heart Failure- Medical Management- Medications

A

Beta blockers
Aldosterone antagonist diuretics
A C E inhibitors
Calcium channel blockers
Digoxin

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18
Q

If patient is given digoxin, what needs to be checked?

A

HR

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19
Q

Heart Failure: Surgical Management

A

Internal cardiac defibrillator

Ventricular assist device

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20
Q

What may patients be given to treat heart failure? Why?

A

Nitroglycerin or vasodilators

Open up the blood vessels

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21
Q

Heart Failure- Self-Management

A

Symptom monitoring
Medication adherence
Lifestyle changes

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22
Q

Heart Failure- Complications

A

Pulmonary edema
Renal failure

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23
Q

Heart Failure: Nursing Management- Assessment and Analysis

A

Signs and symptoms related to weakened cardiac contraction, decreased cardiac output, back up of blood, poor peripheral perfusion

24
Q

Heart Failure: Nursing Diagnoses

A

Impaired oxygenation
Decreased cardiac output
Ineffective peripheral perfusion

25
Q

Heart Failure: Nursing Interventions – Assessments

A

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

26
Q

Heart Failure: Nursing Interventions- Actions

A

Oxygen therapy
Elevate head of bed
Administer medication as ordered
Fluid and sodium restriction

27
Q

Heart Failure: Teaching

A

Medication management
Maintain activity as tolerated
Low-salt diet
Daily weight
Cardiac rehabilitation
Signs and symptoms of worsening heart failure

28
Q

Heart Failure: Evaluating Care Outcomes

A

Reduced dyspnea
Absence of fatigue
Participates in activities of daily living
Reduced hospitalizations

29
Q

Hypertension: Epidemiology

A

78 million people in the U S

30
Q

Hypertension: Risk Factors

A

Race
Gender
Socioeconomic status

31
Q

Hypertension: Clinical Manifestations

A

Headaches
Chest pain
Vision changes
Shortness of breath
Renal dysfunction
Dizziness
Fatigue
Nosebleeds

32
Q

Hypertension:

Medical Management- Diagnosis

A

Two or more bp readings on >2 office visits

33
Q

Hypertension: Treatment

A

Lifestyle changes
Medications

34
Q

Hypertension: Medications

A

Diuretics
Antihypertensives

35
Q

Hypertension:

Lifestyle Management

A

Weight
Diet
Alcohol consumption
Exercise
Stress

36
Q

Hypertension: Complications

A

Dilated cardiomyopathy
Systolic dysfunction
Renal failure
Stroke
Hypertensive crisis

37
Q

Hypertension: Nursing Management- Assessment and analysis

A

Typically no symptoms until disease is advanced

38
Q

Hypertension: Nursing diagnoses

A

Risk for ineffective therapeutic regimen management
Risk for decreased cardiac output

39
Q

Hypertension: Nursing Interventions – Assessments

A

Neurological assessment
Blood pressure
Examination of optic fundi
Auscultation for bruits
Palpation for edema and pulses
Labs
B M I and waist circumference

40
Q

Hypertension: Nursing Interventions – Actions

A

Administer medications as ordered
Provide DASH diet

41
Q

DASH diet

A

1,600 mg sodium restriction

42
Q

Hypertension: Teaching

A

Adherence to medication regimen
Adherence to lifestyle changes
Monitor blood pressure at home
Signs and symptoms of complications

43
Q

Hypertension: Nursing Management – Evaluating care outcomes

A

Increased energy

Absence of energy, headache, dizziness, vision changes

44
Q

Myocardial Infarction Epidemiology

A

630,000 deaths per year

One in four deaths

45
Q

Myocardial Infarction: Risk Factors

A

Smoking
High L D L
Type 2 diabetes
Elevated adrenaline
Obesity
Inactivity
Hypertension

46
Q

Myocardial Infarction: Non-modifiable Risk Factors

A

Male sex

Post menopausal women

Family History

47
Q

Myocardial Infarction: Clinical Manifestations

A

Chest pain
Shoulder and arm pain
`

48
Q

Myocardial Infarction: Medical Management-Diagnosis

A

Laboratory tests (troponin, etc)

Diagnostic testing

49
Q

Myocardial Infarction: Medical Management- Treatment

A

Maximize oxygenation
Control pain
Dilate coronary arteries
Prevent clots
Decrease myocardial workload

50
Q

Myocardial Infarction: Medical Management- Medications

A

Oxygen
Nitroglycerin
Aspirin
Pain medication

51
Q

Myocardial Infarction: Surgical Management

A

Coronary artery bypass graft

52
Q

Myocardial Infarction: Complications

A

Heart failure

Arrhythmias

53
Q

Myocardial Infarction: Nursing Management- Assessment and analysis

A

Signs/symptoms related to lack of oxygen delivery

54
Q

Myocardial Infarction- Nursing Management – Nursing diagnoses

A

Decreased cardiac output
Pain

55
Q

Myocardial Infarction: Nursing Interventions – Assessments

A

Vital signs and pulse oximetry
Characteristics of pain
E C G
Restlessness
Skin color and temperature, peripheral pulses, diaphoresis
Urine output
Labs

56
Q

Myocardial Infarction: Nursing Interventions – Assessments Post-CABG

A

HR and BP
Hemodynamic monitoring
Continuous cardiac monitoring
Heart tones
Breath sounds and continuous oxygen saturation
Core temperature

57
Q

Myocardial Infarction: Nursing Interventions – Actions

A

Administer oxygen
Insert two large-bore IVs
Administer medications as ordered
Continuous E C G monitoring
Bed rest

Medsurg (21 decks)

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