Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiac > Heart Failure/Valvular disease > Flashcards

Heart Failure/Valvular disease Flashcards

0
Q

What are causes of right sided heart failure?

A

Left sided heart failure
Right ventricle MI
Pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is the most common cause of left sided heart failure?

A

Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe left systolic heart failure.

A

Heart cannot pump forcefully enough to perfuse tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe left diastolic heart failure

A

Left ventricle cannot relax preventing filling (preload)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 ways the body compensates for decreased cardiac output due to heart failure?

A
  1. Sns stimulation- increase HR and BP to increase CO
  2. RAAS- activated to increase preload and afterload
  3. Chemical/hormonal response- BNP (promotes vasodilation and diuresis) and ADH (fluid retention with release)
  4. Myocardial hypertrophy- walls thicken to increase force of contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is ejection fraction?
Normal?
< 40% indicates what?

A

% of blood pushed out with ventricular contraction

Normal 60-70%

<40% not ejection enough blood, systolic left heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the best way to diagnosis heart failure?

A

Echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is BNP lab test?

How does the BNP level distinguish from heart or lung failure?

A

blood natriuretic peptide

If high- sob by heart failure
If normal- sob caused by lung dz ( COPD/ pneumonia)

Normally BNP Is very low number

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the common electrolyte imbalances seen with heart failure?

A

Hypokalemia
Hypo magnesium

Hypernaturemia- sodium retention 2* RAAS and diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is acute de compensated HF?

What are symptoms of ADHF?

A

Acute onset of HF

Bags for O2 and CO2 levels – risk for respiratory acidosis
Hemodynamics monitoring for cardiac function and fluid volume status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In left sided heart failure with hemodynamics monitoring, what happens to the pulmonary artery pressure/pulmonary artery wedge pressures?

A

Elevated.- fluid overload need diuretics to remove excess fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

According to HF algorithm
, what are interventions

If EF is >50%…..

If EF is 40-50%…….

If EF is < 40%….

A

If EF is >50%…..encourage HTN control

If EF is 40-50%…….ACE inhibitors, ARB, consider beta blocker

If EF is < 40%….ACE inhibitor, ARB, beta blockers, dig, diuretics, VAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are 4 common nursing diagnosis for HF?

A

Impaired gas exchange

Decreased CO

Activity intolerance

Risk for pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the acronym UNLOAD FAST stand for in trying to improve gas exchange in HF patients?

A 
Upright position
Nitrates
Lasix
Oxygen
ACE inhibitors 
Digoxin

Fluids decreased
Afterload decreased
Sodium restriction
Test dig level, ABGs, k* levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the early manifestations of pulmonary edema you should be assessing for?

A 
Crackles at  base and moving upward
Dyspnea at rest
Confusion/disoriented
Frothy blood tinged sputum
Cold clammy sweaty skin
Anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the priority interventions for treating pulmonary edema?

A

Elevated HOB
Oxygen at 5-6 liters face mask or 10-15 L nonrebreather O2>90%
IVP Lasix/ bum ex
Nitro- reduce preload and afterload
IV morphine to reduce preload and anxiety
Resp therapy for CPAP/BiPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the acronym MAWDS stand for related to patient self management?

A

Meds- take as prescribed, know purpose and SE, avoids NSAIDS
Activity- stay inactive but not too strenuous
Weight- monitor weights daily, report changes
Diet- limit Na+ to 2-3G/ day, fluid intake
Symptoms- report to HCP ( rapid weight gain, decreased exercise tolerance, excessive nocturia, cold/flu symptoms > 3-5 days, dyspnea/ angina at rest, increased edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is mitral valve stenosis?

A

Leaflets ate stiff and narrowed opening prevents blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is mitral valve regurgitation?

A

Leaflets don’t close completely so blood back flows as heart beats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is aortic stenosis

A

Aortic valve narrowing (wear and tear)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

S1 sound is what?

A

Tricuspid and mortal valve close

Lub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

S2 sound is what?

A

Aortic and pulmonary valves close

Dub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where on the EKG do you see the S1 sound?

A

QRS (mitral valve closes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where on the EKG do you see the S2 sound?

A

T wave ( aortic valve closes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What would you hear when auscultating mitral valve regurgitation?

A

Swish-dub

25
Q

What would you hear when auscultating aortic valve regurgitation ?

A

Lub- swish

26
Q

What does the S3 heart sound sound like?

A

Lub dub da
Sloshing in

Occurs after S1 and S2

27
Q

What does the S4 heart sound sound like?

A

Ta lub dub
A stiff wall

Occurs before the S1

28
Q

What are 3 important pt history questions related to valve disease that should be addressed

A

Family hx valve/heart disease

Hx rheumatic fever or infective endocarditis

Hx IV drug abuse

29
Q

What is balloon valvuloplasty?

Where is balloon inserted for mitral valve stenosis?

Where is balloon inserted for aortic valve stenosis?

A

Balloon inflated at level of valve to enlarge

Mitral value- femoral vein

Aortic value- femoral artery

30
Q

Name two surgical procedures for valve repair

Describe each

A

Direct commissurotomy- open heart surgery, incised fused leaflets, debrides calcium deposits

Mitral valve annuloplasty- sutures leaflets to ring

31
Q

What is infective endocarditis?

A

Eroded endocardium and Platelets adhere to leaflets, form vegetation that obstructs blood flow and can embolism

32
Q

What are the signs of infective endocarditis - diagnosis

A

New regurgitation murmur

Positive blood culture

Echocardiogram show vegetation

33
Q

What are osler’s nodules?

What are janeway’s lesions?

What are they associated with?

A

Nodes on palms and soles of feet

Red flat macules on hand and feet

Symptoms of infective endocarditis

34
Q

What is pericarditis?

Acute pericarditis usually follow what type of infection?

A

Inflammation of sac around heart

Follows respiratory infection

35
Q

What is Dressler’s syndrome?

A

Acute pericarditis that occurs 1-12 was after MI

36
Q

Hat are typical symptoms of pericarditis?

A

Chest pain aggravated by deep breathing- worse when supine

Pain may radiate to left neck and shoulder/back

37
Q

What position would help pain from pericarditis?

A

Upright leaning forward

38
Q

What is pericardial effusion?

A

Build up of fluid around heart sac

39
Q

What are s/ of pericardial effusion?

A

JVD at 30*

Signs of decreased CO

Muffled heart sounds

40
Q

What organism is responsible for rheumatic carditis?

A

Inflammation after URI with Group A beta hemolytic streptococci

41
Q

What layers of the heart are affected by rheumatic carditis?

A

All layers– muscles/ valves / pericardium

42
Q

What medications are used to treat the organism the causes rheumatic carditis?

A

Erythromycin or Penicillin

43
Q

What is dilated cardiomyopathy?

A

Ventricles dilate/enlarge and cannot contract and developed left sided heart failure

44
Q

How do beta blockers help HF?

A

Prevent further damage to heart for overwork.

If decrease Hr too much- leads to decreased CO

If see s/s of worsening HF, then too much BB

45
Q

How do CPAP and. BIPAP help HF?

A

Help to push fluid out of the lungs and into circulation to be eliminated.

46
Q

What 2 compensatory mechanism do ACE/ARB ‘s help during HF?

A

RAAS and left ventricular hypertrophy

decrease afterload

47
Q

What are the specifics of IVP Lasix

Onset- peak
Push rate
What to look for for improvement

A

Onset 5 min. Peak 30 min

Push 20mg/min

Working if output increases, O2 says improve and decreased crackles

48
Q

What ️acid base problem is evident with pulmonary edema

A

Respiratory acidosis

Increased CO2 and
paco2 is decreased

49
Q

Describe the levels of NY heart association classification of cardiovascular disability

A

Class 1: no limitations of physical activity
Class 2: slight limitations, comfortable at rest. Ordinary activity causes fatigue, palpitations, dyspnea , angina

Class 3: marked limitations, but comfortable at rest
Class 4: any activity causes symptom- even at rest

50
Q

What are the interventions for infective endocarditis?

A

IV antibiotics

Surgery if and not effective, to remove vegetation

51
Q

What places a patient at risk of infective endocarditis?

A

Valve disease or replacement

Systemic infection

IV drug use

52
Q

What medication is used to treat pericarditis?

A

NSAIDS to reduce inflammation

53
Q

What are the symptoms of rheumatic carditis?

A 
Cardiomegaly
Tachycardia 
New changing murmur 
Pericardial friction rub
New HF
54
Q

What are the sighs of heart rejection after transplant

A 
New bradycardia 
SOB
Fatigue
Fluid gain
Decreased BP 
A-Fib
Decreased activity intolerance
Decreased ejection fraction- late
55
Q

What are some causes of PVCs?

A 
MI
COPD 
HF
Anemia
Hypokalemia 
Hypo magnesium 
Stress
Caffeine
EToh
Infection
Hypoxia
56
Q

What are some symptoms of A-Fib?

A 
Hypotension and decreased CO
Fatigue
Weakness
Sob
Dizziness
Anxiety
Syncope
Palpitations
Chest pain
Decreased BP
57
Q

Wide and distorted P waves are seen with what dysthymias?

A

Vtach and Vfib

Also with PVCs

58
Q

Why would it be difficult to palate peripheral pulses for pt with sinus bradycardia?

A

Heart pumping so slow poor perfusion

59
Q

What is the most common complication of infective endocarditis?

Why?

A

Heart failure

Due to vegetation ️CO is reduce

60
Q

Why is embolism a complication of infective endocarditis

A

Vegetation can trap platelets and bacteria. They can break loose and occlude any area in the body. ( stroke, DVT’s, PE, spleen, kidney)

Cardiac (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions