Heart Faliure Flashcards
What is heart faliure?
An acute or chronic condition in which the heart doesnt pump blood as well as it should resulting in congestion (CHF) of blood backing up and being unable to meet demands of the body.
What is systolic heart faliure? (HFrEF)
Where the ventricles cant pump hard enough during systole
What is diastolic heart faliure? (HFpEF)
Where not enough blood fills into ventricles during the diastole
What does RHF stand for?
Right Heart Failure
What is Right sided Heart Failure?
In right-sided heart failure, the heart’s right ventricle is too weak to pump enough blood to the lungs. As blood builds up in the veins, fluid gets pushed out into the tissues in the body. Right-sided heart failure symptoms include swelling and shortness of breath. i.e blood builds up in peripheral and organ circulation.
What is left sided heart faliure?
Where the left ventricle is unable to pump with enough force, the blood ends up backed up in the lungs causing pulmonary congestion (alveoli are filled with oedema fluid making gas exchange nearly impossible). This means the body is unable to adequately supply body organs leading to low oxygen perfusion and hypoxia.
what are some signs and symptoms of heart faliure?
A cluster of different symptoms, elevated BNP (>80), normal-low LVEF from an echocardiogram.
What is an echocardiogram?
a test of the action of the heart using ultrasound waves to produce a visual display, for the diagnosis or monitoring of heart disease.
What is an LVEF?
Left ventricular ejection fraction (LVEF)
Ejection fraction typically refers to the left side of the heart. It shows how much oxygen-rich blood is pumped out of the left ventricle to most of the body’s organs with each contraction.
Which usually occurs first? LHF or RHF?
LHF usually develops first then RHF because the left ventricle pumps blood throughout the body.
What are some risk factors/causes of HF?
Ischaemia - MI (Elevated TNI) Valve disease Cardiomyopathy Pericarditis Fluid overload (renal faliure, IVF) T2DM HTN Smoking
What does TNI stand for?
Troponin I
These are proteins that are released when the heart muscle has been damaged, such as occurs with a heart attack
What is valve disease?
In heart valve disease, one or more of the valves in your heart doesn’t work properly.
What is cardiomyopathy?
Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body.
What is pericarditis?
Pericarditis is swelling and irritation of the thin, saclike tissue surrounding the heart (pericardium). Pericarditis often causes sharp chest pain.
what are the clinical manifestations (symptoms) of left sided HF?
Dyspnoea (difficult or laboured breathing)
Orthopnoea (Discomfort when breathing while lying down flat)
Paroxysmal nocturnal dysponea (a sensation of shortness of breath that awakens the patient)
Pulmonary congestion - cough, crackle, wheeze
what are the clinical manifestations (symptoms) of right sided HF?
Renal failure
Peripheral Oedema
Ascites (a condition in which fluid collects in spaces within your abdomen)
Enlarged liver and spleen
Distended JVP (bulging jugular vein due to inc pressure of sup vena cava)
Fluid weight gain
What is a distended JVD?
Jugular vein distention or JVD is when the increased pressure of the superior vena cava causes the jugular vein to bulge, making it most visible on the right side of a person’s neck
What are the signs and symptoms of acute heart failure / exacerbation of CHF?
Elevated BNP APO Peripheral Oedema Type 1 resp failure (ABG) Exacerbation of symptoms Elevated JVP Audible crackles on chest assessment CXR - Consolidation
What is a BNP?
Brain natriuretic peptide (BNP) test is a blood test that measures levels of a protein called BNP that is made by your heart and blood vessels. BNP levels are higher than normal when you have heart failure.
What is Consolidation (seen in a chest X-ray) ?
Lung consolidation occurs when the air that usually fills the small airways in your lungs is replaced with something else. Depending on the cause, the air may be replaced with: a fluid, such as pus, blood, or water.
Why do patients have exacerbations of CHF?
Non compliance with meds
Deterioration of disease process
Fluid overload (Transfusion, IVF, renal failure)
Sepsis
What is sepsis?
Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death.
What types of nursing management can we apply to a patient with HF?
Fluid balance (acute phase) Daily weighs IV frusemide Ace inhibitor + beta blocker Daily checks Fluid restriction Lying/standing BP's Oxygen/Airvo Monitoring Electrolytes / renal function If unwell + for escalation consider CCU or ICU for CPAP or blood pressure support
What is IV furosemide?
LASIX® (furosemide) is an infusion medication mainly used to reduce fluid buildup caused by certain underlying medical conditions — such as kidney and/or liver disease, as well as heart failure.
How do ace inhibitors and beta blockers help with HF?
Beta-blockers treat many of the same conditions as ACE inhibitors, including high blood pressure, chronic heart failure, and stroke. Both types of medications also prevent migraines. Unlike ACE inhibitors, however, beta-blockers can help relieve angina (chest pain).
What is Airvo?
a humidifier with integrated flow generator that delivers high flow warmed and humidified respiratory gases to spontaneously breathing patients through a variety of patient interfaces.
What is CPAP?
Continuous positive airway pressure is a form of positive airway pressure ventilation in which a constant level of pressure greater than atmospheric pressure is continuously applied to the upper respiratory tract of a person
what is the CCU?
critical care unit
What type of education and discharge planning do we consider for a patient with HF?
Use the HF discharge pathway
Use the “managing your HF book/pack”
Medication education
Refer to AD/CRISS - Titration + monitoring
Recommend daily checks (weight, breathing, swelling)
Tell the patient when to reach out for help
And ensure the discharge summary includes a (target weight, plan for titration, current BNP, and community service prescription )
What does CRISS stand for?
CRISS = Cardio-Respiratory Integrated Specialist Services
What is titration?
Titration is a way to limit potential side effects by taking time to see how your body will react to a drug. In titration, the medication is started at a low dose. Every couple of weeks, the dose is raised (“up-titrated”) until the maximum effective dose (“target dose”) has been achieved or side effects occur.
