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Nursing Test 3 > Heart Failure > Flashcards

Heart Failure Flashcards

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0
Q

What happens in heart failure

A

The heart is unable to pump an adequate amount of blood to meet tissues metabolic needs

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1
Q

How much is pushed out each time systole happens

A

65-70%

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2
Q

What is normal for cardiac output

A

Normal 4-8 liters/min

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3
Q

Decreased CO symptoms

A

Neurological symptoms change in LOC and if it continues chest pain and SOB

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4
Q

Heart failure results in:

A 
Decreased CO
Decreased SV
Decreased Contractility 
Increased O2 demand on weakening heart 
High risk of MI
Heart gets stiff
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5
Q

With heart failure what can the heart not handle ?

A

Increased volume

Increased afterload

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6
Q

Amount of stretch on the ventricles during diastole

A

Preload

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7
Q

Amount of resistance or workload the left ventricle has to overcome to get blood flow out the aorta to the body and brain

A

Afterload

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8
Q

In who does heart failure occur earlier in

A

Males and African Americans

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9
Q

Risk factors for Heart Failure

A 
CAD
HTN
Diabetes
Smoking
Obesity
Proeinuria
High cholesterol
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10
Q

What does protein in the urine signify

A

That the cells of the kidney shed protein into the urine should be concerned about strain on kidney

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11
Q

Number 1 cause of heart failure

A

Coronary artery disease

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12
Q

Other causes of heart failure besides CAD

A 
MI
Valvular dysfunction
Cardiomyopathy 
HTN
Congenital defects
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13
Q

What is uncontrolled hypertension correlated to

A

Heart failure

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14
Q

Complications of HTN heart

A
  • major risk factor for CAD
  • left ventricular hypertrophy
  • heart failure
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15
Q

What is a hallmark sign of systolic heart failure

A

Decreased LV ejection

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16
Q

Ejection fraction with systolic heart failure

A

<40%

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17
Q

Is diastolic or systolic heart failure most common

A

Systolic heart failure is most common

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18
Q

Sign of systolic heart failure

A

Thin walls

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19
Q

Sign of diastolic heart failure

A

Thick heart walls

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20
Q

Diastolic heart failure deals with _______ filling pressures d/t _____ ventricles

A

High filling pressure d/t stiff ventricles

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21
Q

Diastolic heart failure deals with venous engorgement which lead to pulmonary congestion. What do those two things mean?

A

Venous engorgement- blood cannot get into right atrium it back up in venous side

Pulmonary congestion- backs up into lungs, cannot get out to body. Sx: sob, low pulse ox, crackles, neuro Sx

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22
Q

Diastolic heart failure is the result of what?

A

Left ventricular hypertrophy and chronic HTN

-thick walled

23
Q

Symptoms of left ventricular heart failure

A

Dry hacking cough, fatigue, dyspnea, paroxysmal nocturnal dyspnea, Orthopnea, nocturia, activity intolerance

24
Q

Signs of left ventricular heart failure

A

Tachypnea, tricuspid or mitral murmur, tachycardia, babasilar crackles, S3 S4, decreasing pulse ox, pulmonary edema, cyanosis

25
Q

Symptoms of right ventricular heart failure

A

Weakness, fatigue, RUQ pain, anorexia and GI bloating, nausea

26
Q

Signs of right ventricular failure

A

JVD, hepatomegaly, positive hepatojugular reflex, ascites, weight gain, peripheral edema

27
Q

4 compensatory mechanisms for heart failure

A

Increased sympathetic stimulation
Ventricular dilation
Hypertrophy
Activation of renin-Angiotension system

28
Q

Most common type of cardiomyopathy

A

Dilated

29
Q

Characteristics of dilated cardiomyopathy

A

Idiopathic

Ventricular dilation from pressure. Prone to HF, low CO

30
Q

Characteristics of Hypertrophic cardiomyopathy

A

Left ventricular enlarges and walls thicken d/t being overworked and strained. Decreased cardiac pump

31
Q

Characteristics of restrictive cardiomyopathy

A

Secondary condition. Results from another diagnosis, ventricle restricted and decreased pump ability

32
Q

What is BNP

A

B-Natriuretic Peptide
It is a serum blood draw used to determine the severity of heart failure
Increases with worsening HF
Peptide released from heart in response to left ventricular overload

33
Q

What can a chest x ray show

A

Size of heart and if there is fluid in the lungs

34
Q

Complications of HF

A 
Sudden death 
Dysrhythmias 
Pulmonary edema
Renal failure 
Pneumonia
35
Q

Goals of management for heart failure

A
  • prevent of Myocardial damage
  • prevent progression of existing function
  • prevent exacerbations
  • relieve signs/symptoms
  • improve quality of life
36
Q

How do you decrease intravascular volume

A

By using diuretics to reduce venous return and preload

37
Q

What position would you want somebody who you are trying to decrease preload to be in

A

High Fowlers position with legs dangling at bedside. This helps decrease venous return because of pooling of blood in extremities

38
Q

What should you do before giving a vasodilator? Why?

A

Measure BP and HR before giving because vasodilation will relax and your BP will drop. This will leave more volume in venous side of heart which is what’s needed

39
Q

What can you use to decrease preload?

A
  • vasodilator (Nitroglycerine)

- high Fowlers position w/ legs dangling at bedside

40
Q

What would you use to decrease Afterload

A
  • Nitroglycerin
  • Sulfate-IV–> for chest pain and can also decrease preload causing vasodilation which helps afterload
  • Nesiritide- IV –> given to increase BNP enzyme
  • Nipride- IV –> given for severe HTN, start very slow
41
Q

In what way would you improve gas and oxygenation in a severe case

A

BiPAP or mechanical ventilation

42
Q

What is anxiety many times associated with

A

Dyspnea

43
Q

What is a important nursing function with heart failure

A

Reduce Anxiety! Anxiety can trigger SNS and increase myocardial workload .

44
Q

What do daily weights assess for

A

Fluid retention

45
Q

Why do we care about hemoglobin?

A

Oxygen carrying component

46
Q

Benefit of sodium restriction

A

Improved action of diuretics

47
Q

How do you know if a activity is too stressful

A

BP change of more that 20 mmHg or a pulse increase of 20 BPM

48
Q

What do positive inotropic agents do

A

Increase for of contractility of heart

49
Q

Carvedilol (Coreg)

A
  • One of few beta blockers approved for HF
  • blocks the negative effects of SNS in the failing heart
  • Only to be used with other meds
50
Q

What kind of Med is Digoxin

A

Positive Inotropic Agent

51
Q

What should you do before giving Digoxin

A

Check pulse first

52
Q

If a patient is taking Digoxin what should you have them report

A

Any anorexia, nausea, vomiting

53
Q

Side effects of Nitroglycerin

A

Headache

Hypotension

54
Q

What way can you give NTG

A 
sub lingual tablet
Spray
Transdermal patch
Nitropaste
IV
55
Q

What meds can potentially worsen heart failure

A

Ca++ channel blockers
NSAIDS
Steroids

56
Q

How much weight gain in a week can tell you somebody’s heart failure is worsening

A

3 pounds a week

Nursing Test 3 (10 decks)

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