Heart Failure (M4D) Flashcards
1
Q
heart failure
A
- inability of the ventricles to pump enough blood to meet the body’s metabolic demands
- clinical syndrome
- fluid overload, inadequate tissue perf
- d/t disorder that affects heart’s ability to receive and eject blood
- chronic, progressive syndrome
- manage by lifestyle changes & meds
- no cure, only Tx
2
Q
systolic HF
A
- results in dec blood vol being ejected from the ventricles
- where HF begins
- dec CO, dec systemic BP, dec perf to kidneys
- forces body to go into RAAS (inc aldosterone, activate baroreceptors, leads to diastolic HF)
- ventricular remodelling (inc hypertrophy to meet demands but it makes heart work harder to pump)
- heart does not pump sufficient blood through body –> stimulates heart to work harder –> heart cannot respond –> failure progresses and gets worse and worse
3
Q
L sided HF
A
- L side of heart pumps O2-rich blood around the loop, blood coming from the lungs
- if L side of heart cannot keep up w amount of blood returning from the lungs, fluid backs up into pulm circulation
- blood returned from pulm vessels dec as pressure in L side of heart inc
- inc pressure of blood working to return L side of heart forces fluid from pulm capillaries to push into pulm tissues and alveoli –> pulm edema and impaired gas exchange
- leads to R sided HF
4
Q
R sided HF
A
- R side of heart accepts deoxygenated blood from the body
- if blood trying to return to R side but not able to accomodate it, it will back up and venous return congested
- results in congestion in peripheral tissues and viscera
5
Q
HF risk factors
A
- CAD
- cardiomyopathy
- valvular heart disease
- HTN
- renal dysfx
- age
- DM
- metabolic syndrome
- hyperlipidemia
- A-fib
- smoking
6
Q
L side HF S&S
A
- dyspnea
- SOB
- orthopnea (difficulty breathing while lying flat)
- dry-nonprod cough that leads to frothy pink blood-tinged sputum
- crackles in lungs
- fatigue
7
Q
R side HF S&S
A
- inc jugular vein distention
- edema in lower extremities
- enlargement of liver & spleen
- anorexia
- nausea
- weakness
- weight gain (d/t retention of fluid)
8
Q
interventions for HF
A
- nutrition (DASH diet)
- fluid vol interventions
- activity intolerance
- control SOB
- control anxiety
- impaired sleep
9
Q
fluid volume interventions
A
- diuretic therapy
- daily weight
- fluid restrictions (in/out)
- respiratory assessment
- positioning to reduce preload (semi-fowlers)
- assess for skin breakdown
10
Q
activity intolerance interventions
A
- rest during times of exacerbation (dec workload of heart)
- individualized period of daily exercise gradually inc in duration
- do not exercise in extreme weather (can inc workload on heart)
- pt should be able to talk while exercising
- stop exercising if experiencing SOB, pain, dizziness
- cool-down activities after exercising
11
Q
SOB interventions
A
- supplemental O2; monitor O2 sats
- rest when SOBOE
- raise HOB (never let pt lay flat w/ HF)
- complete respiratory assessment (use of accessory muscles, RR, WOB)
12
Q
controlling anxiety interventions
A
- admin O2 if required
- promote physical comfort and psychological support
- relaxation techniques
- screen for depression
13
Q
impaired sleep interventions
A
- provide required pillows for easy of breathing
- provide chair for pt if they cannot get comfy in bed
- do not lie flat for pts w HF
14
Q
assessments / monitoring for HF
A
- assess Na, K levels and fluid balance
- weigh daily
- respiratory assessments
- assess for JVD
- monitor and evaluate severity of edema
- examine skin turgor & monitor for signs of dehydration
- monitor pulse, BP, signs of postural hypotension
15
Q
evaluation for HF pts
A
- demonstrates tolerance for inc activity
- maintains fluid balance
- demonstrates less anxiety
- makes decision regarding Tx and care
- adheres to self-care regimen
16
Q
diagnostics for HF
A
- echocardiogram (EF)
- chest X-ray
- angiogram
- BNP
- K+ and Na+ (electrolytes)
- CBC, renal fx, LFT
- thyroid stimulating hormone
- urinalysis
- digoxin therapeutic levels
