Heart Failure

Question 1

heart failure

Answer 1

inadequate pumping/filling of the heart

Question 2

risk factors

Answer 2

hypertension and CAD

Question 3

sympathetic Nervous System

Answer 3

release epi/nor epi to increase HR, increase Myocardial contractility

Question 4

neurohormonal compensatory mechanism

Answer 4

kidneys release renin–> angiotensin I–> angitotensis II by vonverting enzyme in lungs.

Question 5

neurohormonal compensatory mechanism

Answer 5

kidneys release renin–> angiotensin I–> angitotensis II by vonverting enzyme in lungs.

Question 6

ventricular dilation

Answer 6

CO decreases, elastic elements of muscle fibers are overstretched and can no longer contract effectively

Question 7

hypertrophy

Answer 7

increase in muscle mass in cardiac wall

Question 8

hypertrophy

Answer 8

increase in muscle mass in cardiac wall

Question 9

counterregulatory hormones

Answer 9

released in response to increased artial volume and ventricular pressure

Question 10

left sided heart failure

Answer 10

most common, prevents normal forward blood flow and causes blood to back up into L atrium and pulmonary veins

Question 11

S/S of L sided heart failure

Answer 11

pulmonary congestion and edema

Question 12

right sided heart failure

Answer 12

right ventricle fails to contract effectively causes blood back up in R atrium and venous circulation

Question 13

S/S of R sided heart failure

Answer 13

Jugular vein distention, hepato/splenomegaly, peri edema

Question 14

clinical manifestations of HF

Answer 14

fatigue, dyspnea, orthopnea, persistent dry cough, tachycardia, dependent edema. >3lb weight gain in 2 days –> contact physician if these occur

Question 15

complications of HF

Answer 15

pleural effusion, dystrhythmias, LV thrombus, hepatomegaly, renal failure

Question 16

pleural effusion

Answer 16

increased pressure in the pleural capillaries

Question 17

dysrthymias

Answer 17

numerous sites fire rapidly and spontaneously

Question 18

LV thrombus

Answer 18

LV contractility, decreased CO, risk for stroke

Question 19

LV thrombus

Answer 19

LV contractility, decreased CO, risk for stroke

Question 20

hepatomegaly

Answer 20

liver becomes congested w/ venous blood, leading to impaired liver function

Question 21

renal failure

Answer 21

decreased CO results in decreased perfusion to kidneys

Question 22

Diagnostic Studies

Answer 22

history, physical exams, underlying cause, chest XR, 12-lead ECG, hemodynamic monitory, 2 dimensional echocardiogram, cardiac cath

Question 23

Diuretics

Answer 23

mainstay of treatment in patients w/ volume overload. Decrease Na reabsorption at various sites w/in the nephrons, and thereby enhancing Na +H2O loss.

Question 24

vasodilators

Answer 24

IV nitroglycerin is a V.D that reduces circulating blood volume

Question 25

morphine

Answer 25

reduces preload and afterload, dialtes pulmonary and systemic blood vessels

Question 26

positive inotropes

Answer 26

increase myocardial contractility

Question 27

ACE inhibitors

Answer 27

primary drug choice for blocking RAAS

Question 28

B-Aderenergic Blockers

Answer 28

directly block the negative effects of the SNS

Question 29

nitrates

Answer 29

cause vasodilation by acting directly on the smooth muscle of vessel wall/coronary artieries

Question 30

S/S of L sided heart failure

Answer 30

pulmonary congestion and edema, crackles, increased HR, pleural effusion, S3 S4 sounds , fatigue, dyspnea, shallow resp. orthopnea, frothy pink sputum

Question 31

S/S of R sided heart failure

Answer 31

Jugular vein distention, hepato/splenomegaly, peri edema, murmurs, weight gain, increased HR, fatigue, anorexia + GI bloating