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nursing > Heart Failure > Flashcards

Heart Failure Flashcards

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1
Q

HF priority problems

A

impaired gas exchange
decreased CO
fatigue/weakness
potential for pulm edema

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2
Q

ways improve gas exchange

A

high-Fowler’s position
admin O
O2 sat 90%

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3
Q

improve CO

A

meds reduce pre/afterload
improve contractility of heart
hemodynamic regulation

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4
Q

meds reduce afterload

A

ACE inhibitor
ARBs
synthetic BNP - vasodilate, increase GFR get rid of Na

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5
Q

meds reduce preload

A

diuretic
venous dilators/nitrates
morphine

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6
Q

meds enhance contractility

A

digoxin
inotropic drugs
beta-adrenergic blockers ie dobutamine

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7
Q

nonsurgical options for HF

A

CPAP - improve oxygenation
CRT - pacemaker/icd
gene therapy - help healthy genes grow

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8
Q

surgical options for HF

A

heart transplant

VAD - mechanical pump bypass ventricle

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9
Q

decrease fatigue and weakness

A

rest for energy management
HR no more than 20 above baseline
do not skip days
gradually increase exercise tolerance

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10
Q

prevent/manage pulm edema

A 
early signs - crackles in bases
dyspnea on rest, disorientation, confusion
high-Fowler's position
O2, Nitro, rapid-acting diuretics
IV morphine
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11
Q

MAWDS

A 
meds
activity
weight
diet
symptoms
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12
Q

indications HF worsening

A 
rapid weight gain
decreased activity tolerance for 2-3 days
cold symptoms
nocturia
dyspnea/angina at rest
increased edema in feet, ankles, hands
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13
Q

Acute HF interventions

A 
cardiac monitoring
O2 sat monitoring
supplemental O2
meds
labs
daily weights
Na/fluid restriction
accurate I&O
abd girth measurement
measure periph edema
careful and frequent cardiac/resp assessment
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14
Q

valvular disease assessment

A

hx rheumatic fever, infective endocarditis, IV drug user
CXR - hypertrophy
ECG
stress test - how respond to stress
ECHO - see structure, EF, look in front of heart
TEE - look back of heart

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15
Q

nonsurgical management of valvular disease

A

rest

meds - diuretics, beta blockers, digoxin, O2, nitrates, vasodilators, anticoags

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16
Q

surgical management of valvular disease

A 
repair
balloon valvuloplasty
direct/open commissurotomy
mitral valve annuloplasty
replacement
17
Q

home care/pt teaching

A

abx for all invasive procedures

rest and conserve energy

18
Q

infective endocarditis

A

microbial inf involving endocardium

those at risk - IV drug users, valve replacement, systemic inf, structural cardiac defects

19
Q

endocarditis manifestations

A

murmur
HF
arterial embolization
petechiae

20
Q

how dx endocarditis

A

positive blood culture

new murmur

21
Q

nonsurgical management of endocarditis

A

antimicrobials

activity balanced w/ rest

22
Q

surgical management of endocarditis

A

remove infected valve
repair/remove congenital shunts
repair injured valve and chordae tendineae
drain abscess of heart

23
Q

causes of pericarditis

A

inflammation/alteration of pericardium

Dressler’s syndrome/inflammation post-MI

24
Q

pericarditis assessment

A

substernal precordial pain radiating left side neck, shoulder, back
grating pain aggravated by breathing, coughing, swallowing
pain worsen w/ supine position, relieved by sitting up/leaning forward
pericardial friction rub

25
Q

pericarditis intervention

A

NSAID for pain/inflammation
antibiotics for bacteria
pericardiectomy

26
Q

manifestation acute cardiac tamponade

A 
JVD
paradoxical pulse - BP higher when breathe in than out
decreased CO
muffled breath sounds
circulatory collapse
27
Q

acute cardiac tamponade emergency care

A 
increased fluid volume
hemodynamic monitoring
pericardiocentesis
pericardial window
pericardiectomy
28
Q

rheumatic carditis

A

usually caused by Strep moving from throat to heart
formation of Aschoff bodies - small nodules/scar tissue formation
impaired contractile fx of myocardium, thickening of pericardium, valvular damage

29
Q

manifestations of rheumatic fever

A 
tachy
cardiomegaly
new/changed murmur
pericardial friction rub
pericardial pain
change in ECG
indication HF
existing Strep inf
30
Q

cardiomyopathy

A

subacute/chronic disease cardiac muscle

CO drops in dilated and hypertrophic cardiomyopathy

31
Q

nonsurgical management of cardiomyopathy

A

meds - diuretics, vasodilating agents, cardiac glycosides
ICD - implantable cardiac defibrillator
avoid toxins
avoid etoh

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