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NURS 252 > heart failure: chapter 25 > Flashcards

heart failure: chapter 25 Flashcards

1
Q

what are 4 symptoms of left sided heart failure. what is a way to remember these symptoms

A

pulmonary edema, cough, sob, dyspnea

LEFT=LUNG

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2
Q

what are 3 symptoms of right sided heart failure

A

pedal edema, jugular vein distension, hepatic congestion

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3
Q

what are the 4 classes of heart failure

A
  1. no limit to normal physical activity
  2. physical activity leads to fatigue and sob
  3. limitation in normal physical activity
  4. symptoms at rest or with any activity
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4
Q

what do positive inotropic drugs do

A

increase the force of myocardial contraction

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5
Q

what are the 2 classes of positive inotropic drugs

A

phosphodiesterase inhibitors, cardiac glycosides

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6
Q

what do positive chronotropic drugs do

A

increase heart rate

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7
Q

what do positive dromotropic drugs do

A

accelerate conduction

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8
Q

what do loop diuretics do

A

reduce symptoms of heart failure secondary to fluid overload

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9
Q

when would digoxin be used for heart failure

A

when all other drugs have been tried

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10
Q

mechanism of action of ace inhibitors

A

prevent sodium and water reabsorption by inhibiting aldosterone secretion

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11
Q

what are the 3 effects of ace inhibitors on the body

A

cause diuresis, decrease blood volume and blood return to the heart, decrease preload and work of the heart

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12
Q

what is a key ace inhibitor

A

lisinopril

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13
Q

3 adverse effects of linsopril

A

hyperkalemia, dry cough, decrease in kidney function

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14
Q

2 effects of angiotensin II receptor blockers on the body

A

vasodilation, decrease systemic vascular resistance

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15
Q

between lisinopril and valsartan, which drug is less likely to cause cough and hyperkalemia

A

valsartan

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16
Q

what is a key ARB

A

valsartan

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17
Q

mechanism of action of beta blockers

A

prevent catecholamine actions on the heart

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18
Q

what are 4 effects of beta blockers on the body

A

reduced hr, delayed av node conduction, reduced myocardial contractility, decreased myocardial automaticity

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19
Q

what is a key beta blocker

A

metoprolol

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20
Q

when would aldosterone antagonists be used

A

in the case of severe heart failure

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21
Q

mechanism of action of aldosterone antagonists and how does this have an effect on the body

A

block the release of aldosterone which decreases the retention of sodium and water

22
Q

what is a key aldosterone antagonist

A

spironolactone

23
Q

what drug class is dobutamine

A

b1 selective vasoactive adrenergic drug

24
Q

mechanism of action of dobutamine and how does this have an effect on the body

A

stimulate b1 receptors which increases contractility leading to increased cardiac output

25
Q

mechanism of action of phosphodiesterase inhibitors (2)

A

increase cAMP, inhibit phosphodiesterase

26
Q

how does the increase in cAMP have an effect on the body (2)

A

positive inotropic response, vasodilation which reduces the force of contractions

27
Q

how does the inhibition of phosphodiesterase have an effect on the body

A

increases availability of calcium for myocardial muscle contraction. heart muscle is able to relax more than normal because it is more responsive

28
Q

indication for phosphodiesterase inhibitors

A

acute heart failure

29
Q

contraindication for phosphodiesterase inhibitors

A

heart failure due to diastolic dysfunction

30
Q

2 adverse effects of phosphodiesterase inhibitors

A

ventricular dysrhythmia, hypokalemia

31
Q

what is the main sign of phosphodiesterase inhibitor toxicity

A

hypotension

32
Q

what is the treatment for phosphodiesterase inhibitor overdose

A

reduce the dose or temporarily discontinue

33
Q

what is a key phosphodiesterase inhibitor

A

milrinone

34
Q

what are 3 adverse effects of milrinone

A

dysrhythmia, hypokalemia, elevated liver enzymes

35
Q

what are 2 drugs that milrinone interacts with

A

diuretics and digoxin

36
Q

what drug classes are first line for treating heart failure

A

ace inhibitors and diuretics

37
Q

what is a negative chronotropic effect

A

decreased heart rate

38
Q

what is a negative dromotropic effect

A

decrease automaticity of the sa node, decreased av node conduction, prolonged atrial and ventricular refractory periods

39
Q

what are 5 effects that cardiac glycosides have on the body

A
  • increased stroke volume
  • decreased heart size during diastole
  • decreased bp
  • increased coronary circulation
  • promote perfusion
  • improve symptom control
40
Q

what is the mechanism of action of cardiac glycosides

A

positive inotropic effect, negative chronotropic effect, negative dromotropic effect

41
Q

2 indications for cardiac glycosides

A

systolic heart failure, atrial fibrilation

42
Q

what is the normal level for cardiac glycosides

A

0.8-2ng/mL

43
Q

what 3 things can increase the risk of cardiac glycoside toxicity

A

low potassium, low magnesium, decreased kidney function

44
Q

what are 4 signs of cardiac glycoside toxicity

A

bradycardia, dizziness, confusion, visual disturbances in the form of blurred or yellow vision

45
Q

what can be used in the case of cardiac glycoside toxicity

A

digoxin immune fab therapy

46
Q

what is digoxin immune fab therapy

A

an antibody is used to inactivate free digoxin

47
Q

what are 3 situations where digoxin immune fab therapy would be used

A

hyperkalemia, life threatening cardiac dysrhythmia, life threatening overdose

48
Q

5 interactions of digoxin

A

bran, ginseng, hawthorn, licorice, st. johns wart

49
Q

what are 6 conditions that can increase the risk of digoxin toxicity

A

pacemaker, hypokalemia, hypercalcemia, dysrhythmia, kidney dysfunction, ventricular fibrillation

50
Q

what should you assess in terms of pulse before administration of a heart failure drug

A

hr at the apical and radial for 1min

NURS 252 (18 decks)

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