Heart Failure: Left & Right Sided Flashcards
what is heart failure
the inability of the heart to pump sufficient blood to meet the needs of the tissues for o2 and nutrients
what most often causes heart failure (3)
CAD
HTN
valve disorders
what are systemic conditions that can affect hrt failure
fever
hypoxia & anemia
dysrhythmias
electrolyte abnormalities
renal failure
thyroid problems
what is consists of left sided heart failure
pulmonary congestion
what is pulmonary congestion
dyspnea
cough
crackles
decreased o2 sat
S3 heart sound
pts who have left sided heart failure will present with
dyspnea on exertion
orthopnea
paroxysmal nocturnal dyspnea
oliguria
confusion
anxiety
restlessness
what are the early stages of pulmonary edema
dry, hacking cough
fatigue
wt gain
worsening edema
degree of dyspnea
what heart failure is pulmonary edema associated with
left sided heart failure
what consists of right sided heart failure
JVD
Dependent edema
hepatomegaly
ascites
weakness, anorexia, wt gain
where is the dependent edema located for rt sided heart failure
feet
ankles
legs
what are diagnostic tests we can run to diagnose heart failure
pulmonary/peripheral edema test
echo
CXR
EKG
electrolytes, BUN, creatinine
BNP
what is our hallmark diagnostic test for heart failure
echo, which confirms HF
what is our hallmark lab for heart failure
BNP
what is the nursing management for heart failure
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
what meds can we give to heart failure pts
ACE inhibitors
ARBS
Beta blockers
Alpha/beta blocker
Digoxin
Diuretics
Anticoagulants
what ACE inhibitor is given for heart failure
captopril
what will the ACE inhibitor promote
vasodilation
diuresis
ACE inhibitors excrete _______ & retain _______
Na & K
dry persistent _______ warrants ______
cough
change
what is the name of the ARB we give for heart failure
losartan
why is an ARB good to use
good to use if pt is intolerant to ACE
what are the names of the beta blockers we can use for heart failure pts
propanolol
metoprolol
beta blockers are used with which med
ACE
we should titrate beta blockers _______
slowly
what can beta blockers cause that could be dangerous if med is abruptly stopped
bradycardia
what alpha/beta blocker can be used for heart failure pts
carvedilol
digoxin is a cardiac _____ used for systolic heart failure, afib & flutter
glycoside
digoxin ______ myocardial contraction & _____ ventricular
increases
decreases
digoxin _____ C.O.
increases
digoxin promotes _____
diuresis
what are s/s of digoxin toxicity
fatigue
depression
malaise
N/V, anorexia
changes in heart rhythm - PVCs
risk of digoxin toxicity increases with
hypokalemia
oral antibiotics
CCBs
quinidine
amiodarone
what is the antidote for digoxin toxicity
digibind
what should we monitor when a pt has digoxin toxicity
apical pulse
hold if < 60
what 3 types of diuretics can we give to a pt with heart failure
thiazide
loop
K sparing
what diet should a heart failure pt be on
low sodium
treating congestive heart failure: UNLOAD FAST
Upright position
Nitrates
Lasix
Oxygen
ACE inhibitors
Digoxin
Fluids (decrease)
Afterload (decrease)
Sodium Restriction
Test (digoxin level, ABGs, K level)
