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Study > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What diseases can lead to HF?

A 
Cardiomyopathy
Valvular heart disease
Endocarditis
Acute MI
HTN
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2
Q

Left sided HF

What happens?

A

Blood doesnt move forward into aorta and out to body. If it doesnt move forward then it backs up to lungs

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3
Q

Left sided HF

What congestion?

A

Pulmonary

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4
Q

Left sided HF

Breathing

A

Dyspnea

Cough

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5
Q

Left sided HF

Sputum

A

Blood tinged frothy sputum

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6
Q

Left sided HF

Appearace

A

Restlessness

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7
Q

Left sided HF

Heart

A

Tachycardia

S3

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8
Q

Left sided HF

Sleep

A

Orthopnea (SOB when laying down–need to sleep propped up)

Nocturnal dyspnea (SOB/cough attacks at night)

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9
Q

Right sided HF

What happens

A

Blood destine move forward into lungs so it goes back into venus system

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10
Q

Right sided HF

Veins?

A

Distended neck veins

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11
Q

Right sided HF

Fluid?

A

Edema
Enlarged organs
Weight gain
Ascites

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12
Q

Systolic HF?

A

Heart can’t contract and eject

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13
Q

Diastolic HF?

A

Ventricles can’t relax and fill

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14
Q

BNP

How is it secreted?

A

Ventricular tissues in the heart when ventricular volumes and pressures in the heart are increased

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15
Q

BNP

Is it a sensitive indicator?

A

Yes

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16
Q

BNP

Can be ___ for HF when CXR does not indicate a problem

A

Positive

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17
Q

BNP

If the client is on nesiritide, turn it off ___ prior to drawing a BNP

A

2 hours

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18
Q

CXR will show what?

A

Enlarged heart, pulmonary infiltrates

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19
Q

What will echocardiogram show?

A

Looks at pumping action or EF of heart. Also gives info about back flow and valve disease

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20
Q

A balloon flotaton catheter than can be floated into the RIGHT side of the heart and pulmonary artery

A

Swan-Ganz (pulm. artery) catheter

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21
Q

What does Swan-Ganz do?

A

Provides info to rapidly determine hemodynamic pressures, CO, and provides access to mixed venous blood sampling

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22
Q

What is DOC for HF: ACE or ARB?

A

ACE (but ARB is used too)

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23
Q

Treatment: ACE (-pril)

What do they do?

A

Suppress RAS

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24
Q

Treatment: ACE (-pril)

Prevent conversion of ?

A

Angiotensin I to angiotensin II

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25
Q

Treatment: ACE (-pril)

Results in arterial ___ and ___ SV

A

Arterial dilation and increased stroke volume

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26
Q

Treatment: ACE (-pril)

Reasons to stop an ACE?

A

Dry cough

Angioedema

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27
Q

Treatment: ARBs (-sartan)

Block angiotensin II receptors and cause a ____ in arterial resistance and decreased BP

A

Decrease

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28
Q

Treatment: ARBs (-sartan)

ACE and ARB both block ____. When we block this, what happens?

A

Block aldosterone

  • we loose NA and H20
  • we retain K
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29
Q

Treatment: Digoxin

Monitor for drug toxicity, esp in the __

30
Q

Treatment: Digoxin

Used when the client is in sinus rhythm or a-fib and had accompanying ___

A

Chronic HF

31
Q

Treatment: Digoxin

Often given in combo with what?

A

ACE
ARB
BB or
Diuretics

32
Q

Treatment: Digoxin

Contraction?

33
Q

Treatment: Digoxin

HR?

34
Q

Treatment: Digoxin

When the HR is slowed, this gives the ventricles more time to fill with blood. Good for systolic or diastolic HF?

A

Diastolic HF

35
Q

Treatment: Digoxin

CO?

36
Q

Treatment: Digoxin

Kidney perfusion

A

Increase (UO goes up)

37
Q

Would diuresis be a good thing or bad thing for this client?

38
Q

We always want to ___ HF clients

39
Q

Normal level of Dig?

40
Q

How do you know dig is working?

A

CO goes up

41
Q

S/s of dig toxicity (early)?

A

ANorexia

NV

42
Q

S/s of dig toxicity (late)?

A

Arrhythmias

Vision changes

43
Q

Before giving dig, do what?

44
Q

When to hold dig for infant, toddler, child, and adult?

A

Infant: Hold if 90-110
Toddler: Hold if less than 70
Child and adult: Hold if less than 60

45
Q

Normal HR for infant? toddler? child?

Normal RR for infant? toddler? child?

A

Infant: HR 140, RR 40

Toddler: HR 120, RR 30

Child: HR 100, RR 20

46
Q

___ + Dig = toxicity

47
Q

T/F: ANy electrolyte imbalance can promote dig. toxicity

48
Q

Treatment: Diuretics

Action?

A

Decreases preload

49
Q

Treatment: Diuretics

When to give?

50
Q

Why give low Na diet?

A

Decreases fluid retention and helps decrease preload

*watch salt substitutes bc they contain excess potassium chloride

51
Q

HOB?

52
Q

Weight

A

Daily and report weight gain of 2-3 lbs

53
Q

Fluid retention think what first?

A

Heart problems

HF, pulm. edema

54
Q

Your natural pacemaker is SA node or sinus node. It sends out impulses that make heart __. If your HR drops to 60 or below, CO can ____

A 
Contract
Be reduced (vital organs don't perfuse well though!)
55
Q

Pacemakers are used to increase the HR with ____

A

Symptomatic bradycardia

56
Q

Pacemakers depolarize the heart muscle and a contraction will occur (_____)

A

Electricity goes through the muscle

57
Q

Repolarization is ?

A

When ventricles are resting and filling with blood

58
Q

Always worry if HR drops below ___

59
Q

Any pacemaker will maintain a certain minimal HR depending on the settings aka the ___

60
Q

A demand pacemaker kicks in when?

A

When client needs it to

61
Q

Fixed rate PM fire at ___

A

Fixed rate constantly

62
Q

Its ok for the rate to increase but never ____

A

Decrease below set rate

63
Q

Always worry if the rate ____ below set rate

64
Q

Post procedure care for PPM

Monitor what?
Most common complication?
Arm?
ROM?

A
  • Monitor incision
  • Complication: Misplacement
  • Immobilize arm; keep client from raising arm higher than shoulder height (wires could come out)
  • Passive ROM to prevent frozen shoulder
65
Q

S/S of PPM malfunction

Failure to capture

A

No contraction will follow stimulus

66
Q

S/S of PPM malfunction

Failure to sense

A

Fire at inappropriate times

67
Q

S/S of PPM malfunction

What can cause loss of capture, failure to sense or any malfunction?

A
  • May not be programmed correctly
  • Electrodes can dislodge
  • Battery may deplete
68
Q

S/S of PPM malfunction

Watch for sign of decreased CO or decreased __

69
Q

Client edu/teaching for PM

Check what daily?
Need what?
Avoid what?
Airport?

A

Check HR daily

Need ID card/bracelet

Avoid electromagnetic fields (cell phones, large motors), MRI, and contact sports

May set of alarm at airport

70
Q

What is ICD? and why?

A

Implantable cardiac device (aka implantable cardioverter defibrillator)

May be used to pace heart or defibrillate people in V-fib
(post op care same as PM)

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