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HF Flashcards

1
Q

HF is a complication that can result from problems such as what?

A
  • CAD
  • cardiomyopathy
  • valvular heart disease
  • endocarditis
  • acute MI
  • HTN
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2
Q

What types of HF are there?

A

Left and right

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3
Q

In left sided HF the blood is not moving forward int o the aorta and out to the body. so if it does not move forward, then ?

A

it will go backwards into the lungs

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4
Q

What are s/s of left sided HF?

A
  • Pulmonary congestion
  • Dyspnea
  • Cough
  • Blood tinged frothy sputum
  • Restlessness
  • Tachycardia
  • S-3
  • Orthopnea
  • Nocturnal dyspnea
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5
Q

In right sided HF the blood is not moving forward into the lung… if it does not move forward then it goes?

A

backward into the venous system

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6
Q

What are s/s of right sided HF?

A
  • Distended neck veins
  • edema
  • Enlarged organs
  • Weight gain
  • Ascites
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7
Q

What is systolic HF?

A

-Heart can’t contract and eject

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8
Q

What is diastolic HF?

A

Ventricles can’t relax and fill

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9
Q

What things diagnose HF?

A
  • BNP
  • CXR
  • Echocardiogram
  • Can put into classes as well (FYI)
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10
Q

What does BNP stand for?

A

B-type natriuretic peptide

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11
Q

When is BNP secreted?

A

By ventricular tissues in heart when ventricular volume and pressures in the heart are increased

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12
Q

Is BNP a sensitive indicator of HF?

A

Yes

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13
Q

Can BNP be positive for HF even if a chest x-ray is not?

A

Yes

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14
Q

If the client is on nesiritide when should happen before drawing a BNP?

A

-Turn it off 2 hours prior

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15
Q

What will a CXR show if HF?

A

and enlarged heart and/or pulmonary infiltrates

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16
Q

What does an echo look at?

A

pumping action or EF of heart

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17
Q

Can an Egg also give you info about back flow and valve disease?

A

yes

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18
Q

How many classes of HF?

A

1-4

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19
Q

What medications are used for treatment of HF?

A
  • ACE inhibitors
  • ARBs
  • BB
  • Digoxin
  • Diuretics
  • IV inotropes
  • Vasodilators
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20
Q

What is the standard medication for HF?

A

ACE inhibitors and ARBs

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21
Q

Ace inhibitors suppress the RAS system and the conversion of angiotensin one to angiotensin two resulting in what?

A

Arterial dilation and increased SV

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22
Q

ARBS block angiotensin 2 receptors, and cause a decrease in arterial resistance and a decreased ?

A

BP

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23
Q

What meds are considered first-line therapy and may be prescribed in addition to ACE inhibitors?

A

BB

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24
Q

BB relax the vessel, decrease BP and after load, which all decreases what?

A

the workload on the heart

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25
ACE inhibitors and ARBs both block what?
aldosterone
26
When we block aldosterone we lose what? Retain what?
- Lose Na and H2O | - Retain K
27
Is it standard practice that a client with HF will be sent home on a ACE inhibitor or a BB? why?
Yes, they decrease workload of heart and will increase CO and keep blood moving forward
28
What should you monitor for with the use of digoxin?
Toxicity (esp in elderly)
29
Digoxin is used when the client is in sums rhythm or fib and has accompanying what?
Chronic HF
30
Is digoxin often given in combination with ACE inhibitors, ARBs, BB or diuretics?
Yes
31
What does digoxin do the the hearts contractions
strengthens it
32
What does digoxin do the HR?
slows it
33
When the HR is slowed, it gives the ventricles more time to do what?
fill
34
With digoxin will CO go up or down?
up
35
With digoxin will kidney perfusion increase or decrease?
Increase
36
Are diuretics food for HF?
yes
37
Why do we always want to diurese a client with HF?
they can't handle the fluid
38
What is a digitalizing dose of digoxin?
loading dose
39
How do you know if digoxin is working?
CO goes up
40
What are s/s of digoxin toxicity?
- Early: anorexia, N/V | - late: arrhythmias and vision changes
41
Before administering digoxin do what?
Check apical pulse
42
Should you monitor electrolytes while taking digoxin?
Yes, K causes most trouble
43
Hypokalemia + digoxin = ?
Toxicity
44
Can any electrolyte imbalance promote digoxin toxicity?
Yes
45
What is the action of diuretics?
Decrease preload
46
When do you give diuretics during a 24 hour period?
in the morning
47
For severe HF or decompensating HF what meds can be used?
- IV inotropes (milrinone or dobutamine) | - Vasodilators (nitroprusside, nesiritide, or initroglycerin)
48
Should someone with HF have a low Na diet? why?
yes, decreased fluid retention and helps decrease preload
49
Do salt substitutes contain excessive K?
Yes
50
Do OTC contain a lot of Na?
yes
51
For HF should you elevate the HOB?
Yes
52
Weigh patient with HF daily and report a weight gain of what?
2-3 lb per day (1-2 kg)
53
Fluid retention= think what first?
Heart problem
54
Should the client report recurring s/s of HF?
Yes
55
Is a pacemaker an option for HF if needed?
Yes
56
What is your natural pacemaker?
SA node
57
What does the SA node do?
Send signals to make heart contract
58
If your HR drops below 600 what can happen to CO?
it can decrease
59
Pacemakers are used when?
to increase HR in symptomatic bradycardia
60
Can pacemaker be temporary or permanent?
Yes
61
Are there fixed pacemakers and demand pacemakers?
Yes
62
Any pacemaker will maintain a certain minimal HR depending on what?
The set rate
63
A demand pacemaker kicks in when?
Only when the client needs it
64
Fixed rate pacemakers fire at what?
a fixed rate constantly
65
With a pacemaker it is ok for the hR to increase but never what?
decrease
66
with a pacemaker when do we worry?
If HR drops below set rate
67
What is the most common complication post-op for a permanent pacemaker?
electrode displacement
68
Should you immobilize the arm after a permanent pacemaker has been placed?
Yes but do assistive Rom to prevent frozen shoulder
69
Should the client raise the arm higher than the shoulder if they just has a permanent pacemaker placed?
No
70
Is it possible that no contraction will follow the stimulus of a pacemaker? what is this called?
Yes, loss of capture
71
Is it possible for the pacemaker fire at inappropriate times? this is called what?
Yes, failure to sense
72
What can cause loss of capture, failure to sense or any malfunction?
- pacemaker not programmed correctly - electrodes dislodged - battery may be depleted
73
What should you watch for with a pacemaker?
any sign of decreased CO or decreased HR
74
What teaching should you tell a client with a pacemaker?
- Check pulse daily - Have ID card/bracelet - Avoid electromagnetic fields (cell phones, large motors) - Avoid MRIs (will shut it off)
75
What is a ICD?
similar to a pacemaker but sends energy shock waves to reset abnormal beats
76
Do you care for a Icd the same as a pacemaker?
yes

Cardiac (8 decks)

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