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Cardiac > HF > Flashcards

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
Q

ACE inhibitors and ARBs both block what?

A

aldosterone

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26
Q

When we block aldosterone we lose what? Retain what?

A
  • Lose Na and H2O

- Retain K

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27
Q

Is it standard practice that a client with HF will be sent home on a ACE inhibitor or a BB? why?

A

Yes, they decrease workload of heart and will increase CO and keep blood moving forward

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28
Q

What should you monitor for with the use of digoxin?

A

Toxicity (esp in elderly)

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29
Q

Digoxin is used when the client is in sums rhythm or fib and has accompanying what?

A

Chronic HF

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30
Q

Is digoxin often given in combination with ACE inhibitors, ARBs, BB or diuretics?

A

Yes

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31
Q

What does digoxin do the the hearts contractions

A

strengthens it

32
Q

What does digoxin do the HR?

A

slows it

33
Q

When the HR is slowed, it gives the ventricles more time to do what?

A

fill

34
Q

With digoxin will CO go up or down?

A

up

35
Q

With digoxin will kidney perfusion increase or decrease?

A

Increase

36
Q

Are diuretics food for HF?

A

yes

37
Q

Why do we always want to diurese a client with HF?

A

they can’t handle the fluid

38
Q

What is a digitalizing dose of digoxin?

A

loading dose

39
Q

How do you know if digoxin is working?

A

CO goes up

40
Q

What are s/s of digoxin toxicity?

A
  • Early: anorexia, N/V

- late: arrhythmias and vision changes

41
Q

Before administering digoxin do what?

A

Check apical pulse

42
Q

Should you monitor electrolytes while taking digoxin?

A

Yes, K causes most trouble

43
Q

Hypokalemia + digoxin = ?

A

Toxicity

44
Q

Can any electrolyte imbalance promote digoxin toxicity?

A

Yes

45
Q

What is the action of diuretics?

A

Decrease preload

46
Q

When do you give diuretics during a 24 hour period?

A

in the morning

47
Q

For severe HF or decompensating HF what meds can be used?

A
  • IV inotropes (milrinone or dobutamine)

- Vasodilators (nitroprusside, nesiritide, or initroglycerin)

48
Q

Should someone with HF have a low Na diet? why?

A

yes, decreased fluid retention and helps decrease preload

49
Q

Do salt substitutes contain excessive K?

A

Yes

50
Q

Do OTC contain a lot of Na?

A

yes

51
Q

For HF should you elevate the HOB?

A

Yes

52
Q

Weigh patient with HF daily and report a weight gain of what?

A

2-3 lb per day (1-2 kg)

53
Q

Fluid retention= think what first?

A

Heart problem

54
Q

Should the client report recurring s/s of HF?

A

Yes

55
Q

Is a pacemaker an option for HF if needed?

A

Yes

56
Q

What is your natural pacemaker?

A

SA node

57
Q

What does the SA node do?

A

Send signals to make heart contract

58
Q

If your HR drops below 600 what can happen to CO?

A

it can decrease

59
Q

Pacemakers are used when?

A

to increase HR in symptomatic bradycardia

60
Q

Can pacemaker be temporary or permanent?

A

Yes

61
Q

Are there fixed pacemakers and demand pacemakers?

A

Yes

62
Q

Any pacemaker will maintain a certain minimal HR depending on what?

A

The set rate

63
Q

A demand pacemaker kicks in when?

A

Only when the client needs it

64
Q

Fixed rate pacemakers fire at what?

A

a fixed rate constantly

65
Q

With a pacemaker it is ok for the hR to increase but never what?

A

decrease

66
Q

with a pacemaker when do we worry?

A

If HR drops below set rate

67
Q

What is the most common complication post-op for a permanent pacemaker?

A

electrode displacement

68
Q

Should you immobilize the arm after a permanent pacemaker has been placed?

A

Yes but do assistive Rom to prevent frozen shoulder

69
Q

Should the client raise the arm higher than the shoulder if they just has a permanent pacemaker placed?

A

No

70
Q

Is it possible that no contraction will follow the stimulus of a pacemaker? what is this called?

A

Yes, loss of capture

71
Q

Is it possible for the pacemaker fire at inappropriate times? this is called what?

A

Yes, failure to sense

72
Q

What can cause loss of capture, failure to sense or any malfunction?

A
  • pacemaker not programmed correctly
  • electrodes dislodged
  • battery may be depleted
73
Q

What should you watch for with a pacemaker?

A

any sign of decreased CO or decreased HR

74
Q

What teaching should you tell a client with a pacemaker?

A
  • Check pulse daily
  • Have ID card/bracelet
  • Avoid electromagnetic fields (cell phones, large motors)
  • Avoid MRIs (will shut it off)
75
Q

What is a ICD?

A

similar to a pacemaker but sends energy shock waves to reset abnormal beats

76
Q

Do you care for a Icd the same as a pacemaker?

A

yes

Cardiac (8 decks)

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