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NURSING 241 (Fall 2018) > Heart Failure > Flashcards

Heart Failure Flashcards

Valvular Disease

1
Q

TRUE / FALSE…

NO TX IS NEEDED FOR A PT WITH MITRAL VALVE PROLAPSE

A

true

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2
Q

Two (2) assessment findings that are unique for Mitral Valve Prolapse

A

DYSPNEA & CHEST PAIN- NOT R/T ACTIVITY

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3
Q

Pharmacological (4) management of patient with Mitral Stenosis

A

1) Digoxin
2) Beta Blockers
3) Diuretics (Furosemide, Spironolactone)
4) Anticoagulant (Warfarin)

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4
Q

Nursing care/management for pt with AORTIC REGURGITATION

A

*VASODILATORS to decrease afterload

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5
Q

Two (2) types of Valves

A

1) Mechanical

2) Tissue

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6
Q

Nursing care R/T Valve replacement

A

1) Monitor for thromboembolism (Stroke or MI)
2) Long term warfarin therapy for mechanical valve
3) Monitor for S/S of endocarditis with tissue valve (ie- fever, HF)
4) Treat Arrythmias (Digoxin, beta blockers, calcium channel blockers)
5) Patient teaching- prophylactic antibiotics

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7
Q

(5) Cardiovascular S/S with Mitral Stenosis

A

PAPFJ

PALPITATIONS
A-FIB w/weak irregular pulse
PITTING EDEMA
FATIGUE
JVD
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8
Q

Heart Failure Dx Testing

A

**12 lead EKG

**CXR

**BNP (b-type natriuretic peptide)- blood test
>100 pg/mL = Heart failure present

**ECHOCARDIOGRAM—Meaures EF
>50% = NORMAL
<40% = Positive for HF

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9
Q

_______ occurs when the opening of the valve is narrowed, and the forward flow of blood through the valve is reduced

A

STENOSIS

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10
Q

Nursing care for pt with pulmonary edema

A 
MAAP-HO
M---Monitor VSS
A---Airway
A---ABG's
P---Potassium
 H---High Fowlers
O---Oxygen
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11
Q

Decreased cardiac output leads to an increase in _________ and __________…..causing an increase in intravascular volume and Vasoconstriction. This causes an increased __________, ___________ and _________________.

A

*Sodium and Water

  • *Increased BP
  • *Increased heart rate
  • *Increased afterload
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12
Q

(5) cardiovascular S/S for pt with Mitral valve prolapse

A 
CHEST PAIN not r/t activity
A-Fib
Pitting Edema
FATIGUE
PALPITATIONS
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13
Q

FOUR (4) S/S OF AORTIC STENOSIS

A
  • DYSPNEA ON EXERTION
  • ORTHOPNEA
  • FATIGUE
  • TRIAD (ANGINA–DYSPNEA –SYNCOPE WITH EXERTION)
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14
Q

_______ occurs when valves do not close completely and blood flows backward through the valve

A

REGURGITATION

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15
Q

DO NOT ADMINISTER DIGOXIN if heart rate is_____________

A

<60 BPM

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16
Q

Nursing care of patient with Mitral stenosis

A
  • Respiratory Assessment
  • CV Assessment
    • Monitor HR for brady cardia r/t digoxin, beta blockers, or calcium channel blockers
    • Monitor I & O r/t diuretic therapy
    • check coagulation studies daily
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17
Q

this repair of the cardiac valve can be done percutaneously or surgically

A

VALVULOPLASTY

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18
Q

SIX (6) S/S OF AORTIC REGURGITATION

A

DOTPWF

Dyspnea
Orthopnea
Tachycardia
Palpitations
Wide Pulse pressure
Fatigue
19
Q

Advantages / Disadvantages of Mechanical valves

A

1) DURABLE
2) Fewer infections
3) need anticoagulation - r/t thrombus risk

20
Q

S/S of LEFT SIDED HEART FAILURE

A

DROWNING-AD

D---difficulty breathing
R---Rales (crackles)
O---Orthopnea
W---Weakness-Fatigue
N---Nocturnal paroxysmal Dyspnea
I----Increased Heart Rate
N---Nagging cough
G---Gaining 2-3lb/day or 5lb/day
A---Altered Mental Status
D---Decreased Urine Output
21
Q

Advantages / Disadvantages of Tissue Valves

A

1) Anticoagulation contraindicated
2) young or older client can receive
3) can be given to pt with med compliance issues

22
Q

______ is the backward flow of blood into the Left Ventricle from the aorta during distole

A

AORTIC REGURGITATION

23
Q

S/S of RIGHT SIDED HEART FAILURE

A

SWELLING

S----swelling (legs, hands, liver, abdomen)
W---Weight Gain
E---Edema
L---Large Distended neck veins
L---Lethargic / fatigued
I---Irregular heart rate / AFIB
N---Nocturia
G---Girth (Hepatosplenomegaly \ ascites)
24
Q

When one or both mitral valve leaflets bulges back into the left atrium during systole, usually without regurgitation

A

Mitral Valve Prolapse (MVP)

25
Q

What is the nurses GOAL with regards to Mitral Stenosis?

A

Restore patient to Normal Sinus Rhythm using medications

26
Q

Replacement of a valve is most often performed with _____________

A

REGURGITATION

27
Q

What are the “4” main concepts affected when discussing Heart Failure?

A
  • OXYGENATION—(Impaired perfusion)
  • COGNITION—(r/t cerebral hypoxia)
  • COMFORT—(r/t ischemia)
  • FLUID / ELECTROLYTES—(excess w/pulmonary congestion)
28
Q

(3) Pulmonary S/S for pt with Mitral Valve Prolapse

A

DYSPNEA NOT R/T ACTIVITY
ORTHOPNEA –sob when laying down
CRACKLES

29
Q

Four (4) Risk Factors for Pulmonary Edema

A

**Left Sided Heart Failure

**Acute MI

**Valvular Heart Disease

**Fluid Volume Overload

30
Q

RISK FACTORS (2) for Mitral Valve Prolapse (MVP)

A

1) Family HX

2) Female Gender

31
Q

The backward flow of blood from the LV into the left atrium during systole because the valve fails to close completely

A

Mitral Regurgitation

32
Q

GOAL OF NURSING CARE FOR PATIENT WITH AORTIC STENOSIS

A

PREVENT COMPLICATIONS

33
Q

(5) Pulmonary S/S with Mitral Stenosis

A

DCHOR

DYSPNEA ON EXERTION 
COUGH (dry)
HEMOPTYSIS
ORTHOPNEA
RECURRENT RESPIRATORY INFECTIONS
34
Q

Four (4) Risk factors for Mitral valve Regurgitation

A
  • Mitral Valve Prolapse
  • Mitral Valve Stenosis
  • Endocarditis
  • Rheumatic Fever
35
Q

(5) S/S of Mitral Valve Regurgitation

A

____CATF___

CHEST PAIN
A-FIB
FATIGUE
TACHYCARDIA

36
Q

Nursing care/interventions (3) for a patient with AORTIC STENOSIS

A
  • nitrates for angina
  • digoxin for impaired pumping of LV (hypertrophied)
  • Diuretics for dyspnea (Sign of left heart failure)
37
Q

Narrowing of the valve opening between the LV and the aorta-resulting in obstruction of blood flow across the valve

A

Aortic Stenosis

38
Q

nursing care R/T Percutaneous Valvuloplasty

A

CBHAV

1) Check puncture site for bleeding/hematoma
2) Bedrest with legs straight
3) HOB elevated <30 degrees
4) Assess for s/s emboli and HF

5) Vascular status affected leg
* color * temp
* movement *Pulse quality
* sensation

39
Q

Three (3) Risk Factors for Aortic Stenosis

A
  • ADVANCED AGE
  • RHEUMATIC FEVER
  • HIGH CHOLESTEROL
40
Q

TWO (2) RISK FACTORS FOR AORTIC REGURGITATION

A

*RHEUMATIC FEVER

**INFECTIVE ENDOCARDITIS

41
Q

________ occurs when the mitral valve doesn’t close properly and the valve leaflets balloon back into the left atrium during systole

A

MITRAL VALVE PROLAPSE (MVP)

42
Q

Two (2) Risk factors for Mitral Stenosis

A

1) Rheumatic Fever

2) Radiation to chest

43
Q

NURSING CARE FOR THE MVP PATIENT

A
  • give beta blockers for chest pain and palpitations
  • Educate pt on the importance of NOT DRINKING alcohol and coffee
  • Heart Failure TX if pt progresses to that point.
44
Q

PULMONARY EDEMA MEDICATIONS (5)

A

~~~MAD DN~~~

M—Morphine—decrease anxiety, cause vasodilation

A—Antihypertensives (ACE, BetaBloc)—decrease afterload

D—Digoxin—improve cardiac output

D—Diuretics—promote fluid excretion

N—Nitroglycerin—decrease preload/afterload

NURSING 241 (Fall 2018) (10 decks)

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