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IM3 > Heart Failure: Left & Right Sided > Flashcards

Heart Failure: Left & Right Sided Flashcards

1
Q

what is heart failure

A

the inability of the heart to pump sufficient blood to meet the needs of the tissues for o2 and nutrients

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2
Q

what most often causes heart failure (3)

A

CAD
HTN
valve disorders

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3
Q

what are systemic conditions that can affect hrt failure

A

fever
hypoxia & anemia
dysrhythmias
electrolyte abnormalities
renal failure
thyroid problems

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4
Q

what is consists of left sided heart failure

A

pulmonary congestion

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5
Q

what is pulmonary congestion

A

dyspnea
cough
crackles
decreased o2 sat
S3 heart sound

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6
Q

pts who have left sided heart failure will present with

A

dyspnea on exertion
orthopnea
paroxysmal nocturnal dyspnea
oliguria
confusion
anxiety
restlessness

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7
Q

what are the early stages of pulmonary edema

A

dry, hacking cough
fatigue
wt gain
worsening edema
degree of dyspnea

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8
Q

what heart failure is pulmonary edema associated with

A

left sided heart failure

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9
Q

what consists of right sided heart failure

A

JVD
Dependent edema
hepatomegaly
ascites
weakness, anorexia, wt gain

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10
Q

where is the dependent edema located for rt sided heart failure

A

feet
ankles
legs

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11
Q

what are diagnostic tests we can run to diagnose heart failure

A

pulmonary/peripheral edema test
echo
CXR
EKG
electrolytes, BUN, creatinine
BNP

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12
Q

what is our hallmark diagnostic test for heart failure

A

echo, which confirms HF

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13
Q

what is our hallmark lab for heart failure

A

BNP

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14
Q

what is the nursing management for heart failure

A

I&O
Daily wt
Lung assessment
Asses for JVD
Assess & eval dependent edema
Close monitoring of VS
Skin turgor
s/s of fluid overload
electrolyte monitoring

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15
Q

what meds can we give to heart failure pts

A

ACE inhibitors
ARBS
Beta blockers
Alpha/beta blocker
Digoxin
Diuretics
Anticoagulants

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16
Q

what ACE inhibitor is given for heart failure

A

captopril

17
Q

what will the ACE inhibitor promote

A

vasodilation
diuresis

18
Q

ACE inhibitors excrete _______ & retain _______

A

Na & K

19
Q

dry persistent _______ warrants ______

A

cough
change

20
Q

what is the name of the ARB we give for heart failure

A

losartan

21
Q

why is an ARB good to use

A

good to use if pt is intolerant to ACE

22
Q

what are the names of the beta blockers we can use for heart failure pts

A

propanolol
metoprolol

23
Q

beta blockers are used with which med

A

ACE

24
Q

we should titrate beta blockers _______

A

slowly

25
Q

what can beta blockers cause that could be dangerous if med is abruptly stopped

A

bradycardia

26
Q

what alpha/beta blocker can be used for heart failure pts

A

carvedilol

27
Q

digoxin is a cardiac _____ used for systolic heart failure, afib & flutter

A

glycoside

28
Q

digoxin ______ myocardial contraction & _____ ventricular

A

increases
decreases

29
Q

digoxin _____ C.O.

A

increases

30
Q

digoxin promotes _____

A

diuresis

31
Q

what are s/s of digoxin toxicity

A

fatigue
depression
malaise
N/V, anorexia
changes in heart rhythm - PVCs

32
Q

risk of digoxin toxicity increases with

A

hypokalemia
oral antibiotics
CCBs
quinidine
amiodarone

33
Q

what is the antidote for digoxin toxicity

A

digibind

34
Q

what should we monitor when a pt has digoxin toxicity

A

apical pulse
hold if < 60

35
Q

what 3 types of diuretics can we give to a pt with heart failure

A

thiazide
loop
K sparing

36
Q

what diet should a heart failure pt be on

A

low sodium

37
Q

treating congestive heart failure: UNLOAD FAST

A

Upright position
Nitrates
Lasix
Oxygen
ACE inhibitors
Digoxin
Fluids (decrease)
Afterload (decrease)
Sodium Restriction
Test (digoxin level, ABGs, K level)

IM3 (47 decks)

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