Heart Failure Flashcards

1
Q
  • complex syndrome resulting from cardiac disorders that impair the ability of the ventricles to fill with and effectively pump blood
  • can be acute or chronic
  • heart is unable to pump enough blood to meet the metabolic demands of the body
  • is the end result of many conditions
A

heart failure

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2
Q
  • abnormal accumulation of fluid in the interstitial tissue and alveoli of lungs
  • both cardiac and non-cardiac disorders can cause this
A

pulmonary edema

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3
Q
  • pulmonary edema due to increased capillary hydrostatic pressure secondary to elevated pulmonary venous pressure
  • accumulation of fluid in the lung interstitium and alveoli as a result of cardiac dysfunction
A

cardiogenic pulmonary edema

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4
Q

what are the primary compensatory mechanisms when the heart begins to fail?

A
  • frank-starling mechanism
  • neuroendocrine responses
  • myocardial hypertrophy
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5
Q
  • the greater the stretch of cardiac muscle fibers, the greater the force of the contraction
  • increased contractile force leads to increased cardiac output
  • increases myocardial O2 demand
  • limited by overstretching
A

frank-starling mechanism

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6
Q

-decreased cardiac output stimulates the:
*sympathetic nervous system and catecholamine release
*stimulates RAAs (with decreased renal perfusion)
-atrial and brain natriuretic peptide are released
-blood flow is redistributed to vital organs
-vasodilation and vasoconstriction, increased HR and BP, salt and water retention etc…
>attempt to balance out system but in long run it is ineffective

A

neuroendocrine response

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7
Q
  • increased cardiac workload causes myocardial muscles to hypertrophy and ventricles to dilate
  • increased contractile force to maintain cardiac output
  • increased O2 demand, cellular enlargement
A

ventricular hypertrophy

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8
Q

what is the leading cause of heart failure?

A

ischemic heart disease aka coronary heart disease

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9
Q

what are some risk factors for heart failure?

A
  • CAD and HTN
  • family hx
  • cardiotoxic drugs
  • smoking
  • obesity
  • alcohol abuse
  • DM
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10
Q

what are the clinical manifestation of left sided heart failure?

A
  • fatigue, activity intolerance
  • dizziness, syncope, dyspnea
  • S3 gallop
  • rales and wheezes
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11
Q

what are the clinical manifestation of right sided heart failure?

A
  • edema of feet, legs, sacrum
  • anorexia, nausea
  • RUQ pain
  • neck vein distension
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12
Q

what respiratory complications can occur with heart failure?

A
  • dyspnea on exertion
  • shortness of breath
  • tacypnea
  • orthopnea
  • dry cough
  • rales in lung bases
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13
Q

what gastrointestinal complications can occur with heart failure?

A
  • anorexia, nausea
  • abdominal distension
  • liver enlargement
  • right upper quadrant pain
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14
Q

what muskuloskeletal complications can occur with heart failure?

A

-fatigue, weakness

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15
Q

what neurologic complications can occur with heart failure?

A
  • confusion
  • impaired memory
  • anxiety, restlessness
  • insomnia
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16
Q

what cardiovascular complications can occur with heart failure?

A
  • activity intolerance
  • tachycardia
  • palpitations
  • S3, S4 heart sounds
  • elevated central venous pressure
  • neck vein distension
  • hepatojugular reflux
  • splenomegaly
17
Q

what genitourinary complications can occur with heart failure?

A
  • decreased urine output

- nocturia

18
Q

what integumentary complications can occur with heart failure?

A
  • pallor or cyanosis
  • cool, clammy skin
  • diaphoresis
19
Q

what metabolic complications can occur with heart failure?

A
  • peripheral edema

- weight gain

20
Q

what are the main goals for care of a client in heart failure?

A
  • slow progression of disease
  • reduce cardiac workload
  • improve cardiac function
  • control fluid retention
21
Q

what diagnostic tests are available for heart failure?

A
  • blood tests to detect atrial and brain natriuretic peptides
  • serum electrolytes
  • urinalysis, BUN, serum creatinine
  • liver function
  • thyroid function
  • ABGs
  • CXR
  • ECG
  • echocardiogram
22
Q
  • study of forces involved in blood cirdulation

- used to assess cardiovascular function in clients who are critically ill or unstable

A

hemodynamics

23
Q

what are some of the pharmacological therapies available for heart failure?

A
  • ACE inhibitors (angiotensin converting enzyme)
  • angiotensin II receptor blockers
  • beta blockers
  • diuretics
  • vasodilators
  • digitalis
  • antidysrrythmias
24
Q

what devices are available for circulatory assistance in heart failure clients?

A
  • intra-aortic balloon pump

- left ventricular assist device

25
Q

what surgeries are available for heart patient clients?

A
  • cardiac transplants (limited by available hearts)
  • cardiomyoplasty
  • ventricular reduction
26
Q

what complementary therapies are available for heart failure clients?

A
  • hawthorne

- coenzyme Q, magnesium, thiamine