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Nursing Test 3 > Heart Failure > Flashcards

Heart Failure Flashcards

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
Signs of left ventricular heart failure
Tachypnea, tricuspid or mitral murmur, tachycardia, babasilar crackles, S3 S4, decreasing pulse ox, pulmonary edema, cyanosis
25
Symptoms of right ventricular heart failure
Weakness, fatigue, RUQ pain, anorexia and GI bloating, nausea
26
Signs of right ventricular failure
JVD, hepatomegaly, positive hepatojugular reflex, ascites, weight gain, peripheral edema
27
4 compensatory mechanisms for heart failure
Increased sympathetic stimulation Ventricular dilation Hypertrophy Activation of renin-Angiotension system
28
Most common type of cardiomyopathy
Dilated
29
Characteristics of dilated cardiomyopathy
Idiopathic | Ventricular dilation from pressure. Prone to HF, low CO
30
Characteristics of Hypertrophic cardiomyopathy
Left ventricular enlarges and walls thicken d/t being overworked and strained. Decreased cardiac pump
31
Characteristics of restrictive cardiomyopathy
Secondary condition. Results from another diagnosis, ventricle restricted and decreased pump ability
32
What is BNP
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
What can a chest x ray show
Size of heart and if there is fluid in the lungs
34
Complications of HF
``` Sudden death Dysrhythmias Pulmonary edema Renal failure Pneumonia ```
35
Goals of management for heart failure
- prevent of Myocardial damage - prevent progression of existing function - prevent exacerbations - relieve signs/symptoms - improve quality of life
36
How do you decrease intravascular volume
By using diuretics to reduce venous return and preload
37
What position would you want somebody who you are trying to decrease preload to be in
High Fowlers position with legs dangling at bedside. This helps decrease venous return because of pooling of blood in extremities
38
What should you do before giving a vasodilator? Why?
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
What can you use to decrease preload?
- vasodilator (Nitroglycerine) | - high Fowlers position w/ legs dangling at bedside
40
What would you use to decrease Afterload
- 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
In what way would you improve gas and oxygenation in a severe case
BiPAP or mechanical ventilation
42
What is anxiety many times associated with
Dyspnea
43
What is a important nursing function with heart failure
Reduce Anxiety! Anxiety can trigger SNS and increase myocardial workload .
44
What do daily weights assess for
Fluid retention
45
Why do we care about hemoglobin?
Oxygen carrying component
46
Benefit of sodium restriction
Improved action of diuretics
47
How do you know if a activity is too stressful
BP change of more that 20 mmHg or a pulse increase of 20 BPM
48
What do positive inotropic agents do
Increase for of contractility of heart
49
Carvedilol (Coreg)
- 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
What kind of Med is Digoxin
Positive Inotropic Agent
51
What should you do before giving Digoxin
Check pulse first
52
If a patient is taking Digoxin what should you have them report
Any anorexia, nausea, vomiting
53
Side effects of Nitroglycerin
Headache | Hypotension
54
What way can you give NTG
``` sub lingual tablet Spray Transdermal patch Nitropaste IV ```
55
What meds can potentially worsen heart failure
Ca++ channel blockers NSAIDS Steroids
56
How much weight gain in a week can tell you somebody's heart failure is worsening
3 pounds a week

Nursing Test 3 (10 decks)

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