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NUR 221 > Heart failure > Flashcards

Heart failure Flashcards

1
Q

What is the normal CO in an adult?

A

4-6 L/min

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2
Q

What is a normal ejection fraction in an adult?

A

50-70%

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3
Q

HR x SV=

A

CO

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4
Q

What is preload?

A

When myocardial muscle stretches that allows for VENTRICULAR FILLING

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5
Q

What is afterload?

A

What the ventricle has to push against to eject blood into circulation.

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6
Q

What meds can reduce afterload?

A

CCB’s, BB, nitroglycerin (vasodilator)

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7
Q

What meds can increase afterload?

A

epinephrine/norepinephrine, dopamine (vasopressors)

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8
Q

How can a persons MAP be calculated?

A

2(diastolic)+systolic/3

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9
Q

What is a normal MAP range?

A

70-105 mmHg

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10
Q

Once the MAP is failing to be maintained the oxygen metabolizes anaerobically and causes what to build up?

A

Lactic acid (lactic acidosis)

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11
Q

____ ____ happens when the heart is unable to pump enough blood to meet the bodies demands due to heart muscle being damaged/stressed.

A

Heart failure

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12
Q

What Medical emergency involving fluid in the interstitial tissue and alveoli of lung is a consequence of HF, that can lead to sudden cardiac death?

A

Pulmonary edema

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13
Q

This mechanism involves the stretching of muscle fibers past the limit = ineffective contractions = increased CO.
(The more the heart fills with blood, the stronger the contractions.)

A

Frank Starling Mechanism

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14
Q

What mechanism occurs when the increased cardiac workload causes the muscles to hypertrophy and ventricles to dilate?

A

Ventricular hypertrophy

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15
Q

What happens when the heart chambers and myocardium adapt to increased fluid volume and pressure?

A

Ventricular remodeling

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16
Q

What sign would we see in a patient that is at a critical level of cardiac decompensation?

A

activity intolerance at rest

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17
Q

What classification of HF, is when ventricles fail to contract adequately to eject enough volume of blood into the arterial system?

A

systolic failure

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18
Q

What classification of HF is when the heart cant relax during diastole which then disrupts normal filling?

A

Diastolic Failure

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19
Q

What are two common causes of Left sided HF?

A
  • -HTN

- -Coronary Heart disease

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20
Q

Low output HF is usually caused by….

A
  • -HTN

- -cardiomyopathy

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21
Q

High output HF is usually caused by….

A

—Hypermetabolic state (anemia, hyperthyroidism, infection)

22
Q

What are some RF for HF?

A
  • -hx. of MI
  • -CAD
  • -Smoking
  • -HTN
  • -Diabetes
  • -Heart valve disease
  • -Sleep apnea (can also lead to HF)
23
Q

What are some clinical manifestations of Left sided HF?

A
  • -Fatigue (early sign)
  • -Dyspnea, SOB, and cough
  • -Orthopnea
  • -Cyanosis
  • -crackles (hallmark sign)
24
Q

What are some clinical manifestations of right sided HF?

A
  • -Edema
  • -Anorexia, nausea
  • -RUQ
  • -Engorged Liver
  • -JVD (hallmark sign)
25
Q

If someone has right sided HF, where can they develop edema?

A
  • -feet and legs

- -sacrum (if bedridden)

26
Q

What signs may a person see with (Class 3) moderate HF?

A
  • -Increased physical limitations
  • -fatigue
  • -SOB
  • -palpitations
27
Q

What are some manifestations of Pulmonary edema?

A
  • -SOB
  • -Orthopnea
  • -Pink Frothy Sputum
  • -Crackles
  • -Anxiety (impending doom)
28
Q

What hormone is released by the heart muscle in response to the heart muscle stretching?

A

BNP (increased)

29
Q

What OTC meds should be avoided with heart meds?

A

NSAIDS

30
Q

What type of diet should a patient with heart failure be on?

A
  • -2g sodium
  • -heart healthy
  • -fluid restriction
31
Q

How often should a patient that is not on bed rest exercise per week?

A

3-7 days per week

32
Q

If a pt. had a heart transplant, What should the nurse remember with a patient that has a chest tube?

A
  • -Dont strip tubing
  • -Monitor q15min. initially
  • -maintain patency
33
Q

What are two major concerns after a heart transplant?

A
  • -infection

- -rejection

34
Q

After a heart transplant what type of meds therapy is a patient started on?

A

–immunosuppresants

35
Q

What alternative therapy acts as a natural ace inhibitor?

A

–Hawthorne (shrubby tree)

36
Q

What nutritional supplements can be taken in a patient with HF?

A
  • -Coenzyme Q10
  • -Magnesium
  • -Thiamine
37
Q

What should the nurse monitor in a patient with HF?

A
  • -BNP
  • -VS
  • -MAP
  • -I and O’s
  • -abdominal girth
38
Q

What are some nursing interventions for a pt. with HF?

A
  • -O2
  • -encourage bed rest, rest periods
  • -Elevate HOB
  • -Restrict fluids
  • -Mouth care (offer ice chips/hard candies)
  • -offer 6 small meals/day
39
Q

The nurse should auscultate heart and breath sounds every ___ hours.

A

4

40
Q

The patient should be educated on signs of a cough. What would the nurse tell the patient?

A
  • -Ace inhibitors cause dry cough (normal)

- -Wet cough indicates Left side HF

41
Q

The pt. should call the doctor if they gain….

A

> 2 lbs. in a day

42
Q

When the nurse gets a daily weight, they should make sure to….

A

–weigh same time each day in the morning in same clothes, use bathroom

43
Q

What is going on when a person has right sided HF?

A

Lose perfusion to the lungs, blood congests backwards to the body.

44
Q

What is going on when a person has left sided HF?

A

Blood congests backwards to the lungs and lose perfusion to the body.

45
Q

What is activated in response to low perfusion to the kidneys?

A

RAAS (Renin angiotensin Aldosterone System)

46
Q

How can RAAS worsen HF?

A

Increasing volume overload and increasing afterload

47
Q

What source of oxygen should be used if a person has decompensated HF?

A

Bi-Pap

48
Q

What maneuver should be avoided in a patient with HF because it puts strain on heart, especially if they are hemodyamically unstable?

A

Valsalva maneuver

49
Q

When a patient has decompensated HF, what signs would the nurse see?

A
  • -Increased preload
  • -increased afterload
  • -low cardiac index (CO)
  • -Tachycardia
50
Q

What signs may a person see in stage 4 (severe) HF?

A
  • -Any physical activity causes discomfort

- -cardiac insufficiency at rest

NUR 221 (9 decks)

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