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Nursing 4 Exam 1 > Heart Failure > Flashcards

Heart Failure Flashcards

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0
Q

What is HF a long term effect of?

A

Coronary heart disease and MI.

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1
Q

What is heart failure?

A

Inability of the ventricles to fill during preload and the inability of the heart to pump out blood during after load.

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2
Q

What are the risk factors for HF?

A 
HTN
diabetes
Smoking 
Obesity 
High cholesterol
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3
Q

What causes impaired myocardial function?

A

Coronary heart disease
Cardiomyopathies
Rheumatic fever
Infective endocarditis

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4
Q

What causes an increased cardiac workload?

A

Hypertension
Valve disorders
Anemia
Congenital heart defects

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5
Q

What is the frank starling mechanism?

A

The SNS is stimulated and releases NE which increases the HR and contractility. NE also causes arterial and venous vasoconstriction which increase ventricular filling and myocardial stretch)

*comoensatory mechanism may fail if the heart is over stretched and can no longer contract effectively.

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6
Q

What does activation of the RAAS do?

A

The decreased renal perfusion causes kidneys to release renin.
Produces vasoconstriction and release of ADH.
Cause vasoconstriction and salt and water retention which causes an increased filling and increased contraction
** but eventually they will over stretch and fail

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7
Q

What does myocardial hypertrophy do?

A

The ventricles remodel and dilate to accommodate. The additional stretch causes more effective contractions but in the long run the walls of the heart thing out and degenerate.

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8
Q

When does decompensation occur?

A

When these mechanisms can no longer maintain adequate CO and inadequate tissue perfusion results.

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9
Q

What is systolic heart failure?

A

Impaired contraction

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10
Q

What causes systolic HF?

A

Cardiomyopathies
Ischemia
Infarction
Inflammation

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11
Q

What are he signs and symptoms of systolic HF?

A

Weakness, fatigue, and activity intolerance

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12
Q

What is diastolic HF?

A

Impaired ability of the ventricle to relax and fill

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13
Q

What is the cause of diastolic HF?

A

Ventricular hypertrophy

Impaired relaxation of cardiac muscle

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14
Q

What are the signs and symptoms of diastolic HF?

A

SOB, tachypnea, and respiratory crackles if the left ventricle is affected.

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15
Q

What is left sided HF caused by?

A

CAD and HTN

16
Q

What are the signs and symptoms of left sided HF?

A

Fatigue and activity intolerance are early CM.

SOB, cough (pink frothy sputum), orthopnea, cyanosis, and inspiratory crackles and wheezes.

17
Q

What are the clinical manifestations of HF?

A

Edema
Paroxysmal nocturnal dyspnea (when supine)
Nocturia
Weight changes (5lbs in a week)

18
Q

What are the CM of decompensation HF?

A 
Pulmonary edema (tachycardia, hypotension, ventricular gallop,hypoxemia)
Cyanosis and clammy cold skin

*all of these are cardiogenic

19
Q

What test will be order for HF?

A

BNP between 100-300 indicates HF. JUST TESTS FOR SEVERITY.

20
Q

What causes right sided HF?

A

Pulmonary diseases

21
Q

What are the signs and symptoms of right sided HF?

A

Edema in the feet, legs, and sacrum
GI congestion (anorexia and nausea)
JVD
upper right quadrant pain from liver engorgment or splenomegaly

22
Q

What do diuretics do?

A

They prompt sodium and water excretion.

watch for significant electrolyte and fluid loss.

23
Q

What do ACEI do?

A

Interrupt the conversion of angiotensin I to angiotensin II.
Decreasing cardiac work and increasing CO.
They reduce the progression and manifestations of heart failure.

24
Q

What should we tell patient who are taking ACEI?

A

They will experience a dry cough

25
Q

What are ARBS?

A

They block the receptor.

They slow the progression of HF and reduce its manifestations.

26
Q

What do vasodilators do?

A

Relax smooth muscle in the vessels, causing dilation.

27
Q

What do intotropic agents do?

A

Digitalis works to slow and strengthen contractions,

28
Q

What do sympathomimetic agents do?

A

Raise everything up, produce a fight or flight response.

29
Q

What are respiratory manifestations of pulmonary edema?

A 
Tachycardia 
Paroxysmal nocturnal dyspnea
Labored respirations
Cough productive of frothy pink sputum
Dyspnea
Crackles, wheezes
Orthopnea
30
Q

What are cardiovascular clinical manifestations of pulmonary edema?

A 
Tachycardia
Cool, clammy skin
Hypotension
Hypoxemia
Cyanosis
Ventricular gallop
31
Q

What are neurological clinical manifestations of pulmonary edema?

A

Restlessness,feeling of impending doom, anxiety

32
Q

What does an ECCHO look for?

A

Left ventricular function

33
Q

What does an ECG look for?

A

Dysthymias, myocardial ischemia, or infarction

34
Q

What does a chest X-ray look for?

A

Pulmonary congestion

35
Q

What do thyroid function tests look for?

A

Hyperthyroidism or hypothyroidism because they can both be a contributing factor to HF

Nursing 4 Exam 1 (5 decks)

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