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Med Surg II -- EXAM 2 > Heart Failure (Week 6) > Flashcards

Heart Failure (Week 6) Flashcards

1
Q

What is heart failure? (pathophysiology)

A

decreased cardiac output (CO) which leadds to a decrease in blood flow to the kidneys & other vital organs / tissues

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2
Q

What do the following adrenergic receptors do?

  • Alpha
  • Beta 1
  • Beta 2
  • Dopaminergic

KNOW THIS!!!

A
  • Alpha: vasoconstriction of peripheral arterioles
  • Beta 1: increased HR, conduction, & contractility
  • Beta 2: Vasodilation of peripheral arteries & bronchodilation
  • Dopaminergic: Dilation of renal & mesenteric arteries
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3
Q

What are ALPHA adrenergic receptors responsible for?

KNOW THIS!!!

A

Vasoconstriction of peripheral arterioles

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4
Q

What are BETA 1 adrenergic receptors responsible for?

KNOW THIS!!!

A

Increased heart rate, conduction, & contractility

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5
Q

What are BETA 2 adrenergic receptors responsible for?

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A

vasodilation of peripheral arteries & broncho dilation

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6
Q

What are DOPAMINERGIC receptors responsible for?

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A

dilation of renal & mesenteric arteries

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7
Q

What is preload?

KNOW THIS!!!

A

VOLUME in the ventricles at the end of diastole

more volume = higher pressure

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8
Q

What is afterload?

KNOW THIS!!!

A

Pressure or resistance the ventricles have to push against

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9
Q

What does afterload impact?

A

cardiac performance

inverse relationship

  • ↑ afterload = ↓ cardiac output
  • ↓ afterload = ↑ cardiac output
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10
Q

What happens to preload in the following situations?

1.) Patient is in Hemorrhagic Shock
2.) Patient is given a Fluid Bolus

KNOW THIS!!!

A

1.) Hemorrhagic Shock causes a decrease in preload (loss of fluid = low BP)

2.) Fluid Bolus causes increase in preload (giving fluid to the pt = increased BP)

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11
Q

What happens to afterload during the following scenarios?

1.) Septic Shock
2.) Patient is on or is given Nipride, Nitroglycerin, Lasix, Morphine, or ACE inhibitiors
3.) Patient is on or is given a vasopressor like Levophed

KNOW THIS!!!

A

1.) Septic Shock causes INCREASED afterload (ventricles must overcome a greater pressure than usual)

2.) Patient is on or is taking Nipride, Nitroglycerin, Lasix, Morphine, or ACE Inhibitors causes decreased afterload (ventricles must overcome a lower presser than usual)

3.) Patient is on or is given Vasopressors like Levophed causes INCREASED afterload

  • INCREASED afterload: ventricles must overcome a greater pressure than ususal
  • decreased afterload: ventricles must overcome a lower pressure than usual
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12
Q

What is one unique thing about ACE Inhibitors regarding preload & afterload?

A

ACE Inhibitors decrease BP but there is NO Reflex Tachycardia

  • Reflex Tachycardia: due to a lowered BP, the body tries to compensate by increasing the HR
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13
Q

Common side effects of ACE Inhibitors

KNOW THIS!!!

A
  • ANGIOEDEMA
  • Headache
  • Nagging dry cough
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14
Q

What is contractility?

A

force the heart beats with & how effective the heart is beating

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15
Q

What do the following drugs / disorders / treatments do to contractility?

  • Dobutamine (vasopressor)
  • Digoxin
  • Acidosis
  • Fluid bolus administration
A
  • Dobutamine (vasopressor) decreases contractility
  • Digoxin INCREASES contractility (pts w/ A-fib have poor contractility
  • Acidosis decreases contractility
  • Fluid bolus administration INCREASES contractility
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16
Q

What is End Diastolic Volume?

A

How much blood is in the ventricles before contraction

17
Q

What is normal ejection fraction (EF)?

A

greater than (>) 55%

18
Q

What is the difference in depressed/reduced CHF (HFrEF / systolic HF) and preserved CHF (HFpEF / diastolic HF)?

KNOW THIS!!!

A
  • Reduced CHF (HFrEF / Systolic) = EF under 40%
  • Preserved CHF (HFpEF / Diastolic = EF > 40%
19
Q

What is Reduced CHF / HFrEF (systolic HF)?

A

EF under 40%

20
Q

What is Preserved HF / HFpEF (diastolic HF)?

A

EF over 40%

21
Q

What are the symptoms of left sided heart failure?

KNOW THIS!!!!! ON EXAM!!!!!

A

PULMONARY
* cough
* crackles
* shortness of breath
* pulmonary congestion
* pulmonary edema
* cough with frothy sputum
* orthopnea
* dyspnea

Left Sided = Lungs

22
Q

What are the symptoms of right sided heart failure?

KNOW THIS!!!!! ON EXAM!!!!!

A

PERIPHERAL
* edema (dependent)
* JVD
* weight gain
* ascietes

23
Q

What is the difference in inotropes & chronotropes?

KNOW THIS!!!!! ON EXAM!!!!!

A
  • Inotropes affect contractility
  • Chronotropes affect the HR
24
Q

What do inotropes impact?

A

Contractility

  • + inotrope = INCREASED contractility
  • - inotrope = decreased contractility
25
Q

What do chronotropes affect?

A

heart rate

  • + chronotrope = INCREASED HR
  • - chronotrope = decreased HR
26
Q

List drugs that are positive isotropes.

A
  • dobutamine
  • dopamin
  • digoxin
  • epinephrine
27
Q

Are the following drugs positive or negative chronotropic drugs?

  • Dopamine
  • Digoxin
  • Epinephrine

KNOW THIS!!!!! ON EXAM!!!!!

A
  • Dopamine & Epinephrine = + chronotropes
  • Digoxin = - chronotrope
28
Q

What is pulmonary edema and what are potential causes?

A

Too much fluid in the lungs

  • heroin overdose
  • head injury
  • anterior wall MI
  • cardiomyopathy
29
Q

What medication is used to treat SVT?

KNOW THIS!!!!! ON EXAM!!!!!

A

Adenosine (adenocard)

30
Q

What medication is used to treat bradycardia?

KNOW THIS!!!!! ON EXAM!!!!!

A

Atropine

31
Q

What medication is used to treat V-Fib, PEA, & asystole?

KNOW THIS!!!!! ON EXAM!!!!!

A

Epinephrine

32
Q

What are the “significant six” in terms of education for patients who are having or have had cardiac resynchronization therapy (CRT)?

A

1.) Smoking cessation
2.) Weight monitoring
3.) Symptoms to report
4.) Diet
5.) Activity
6.) Medications

33
Q

What is Left Ventricular Ejection Fraction (LVEF)?

A

Ratio of stroke volume to end diastolic volume

34
Q

A patient is diagnosed with heart failure & is prescribed digoxin (Lanoxin) and furosemide (Lasix). Before administering furosemide to the patient, which lab result should the nurse review?

a.) Serum sodium (Na+)
b.) Serum troponin
c.) Serum potassium (K+)
d.) BUN

A

c.) Serum potassium (K+)

35
Q

A patient who has a history of pulmonary valve stenosis tells the HCP, “I don’t have a lot of energy anymore, and both my feet get swollen in the late afternoon”. Which of these problems does the HCP conclude is the likely cause of these clinical findings?

a.) Acute pericarditis
b.) DVT
c.) Peripheral artery disease
d.) Right ventricular failure

A

d.) Right ventricular failure

Med Surg II -- EXAM 2 (10 decks)

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