Lecture 4 Part 2 EXAM 2 Flashcards

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1
Q

What is Heart failure?

A

Occurs when heart muscle is impaired and no longer pumps sufficient blood to body tissues and organs.
Can occcur form any kind of Cardiovascular disease

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2
Q

How many people in the United States are affect by Heart failure?

A

5 million

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3
Q

What are the causes of Heart failure and what illness is associated with it?

A
  • Myocardial Infraction (MI) and hypertension are most common cause
  • Associated w/ Thyroid disease, renal insufficiency and pulmonary disease
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4
Q

When does signs of HF occurs?

A

Intial- at exertion
Progression- at rest

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5
Q

What can HF lead to ?

A

pulmonary edema

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6
Q

What are the clinical manifestation of HF?

A
  • Left Ventricular HF
  • Right Ventricular HF
  • Both left and Right Ventricular HF
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7
Q

What is Left ventricuular HF

A
  • Inability of the left ventricle to pump blood to the body tissues
  • occurs before right ventricular HF
  • May back up causing leak into the lungs
  • Occurs when PT is supine
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8
Q

What are signs and symptoms of left heart failure ?

A
  • Classic sign dyspnea (shortness of breath)
  • Tachypnea
  • Dry cough
  • Cardiac Asthma
  • Pale and cool to touch
  • Diaphoresis (sweating)
  • Increased BP
  • Pluse rapid and thready
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9
Q

What is the ASA level for a PT with Left HF?

A

ASA III or IV

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10
Q

What is right heart failure?

A

Inability of the heart to pump blood from the systemic circulation to the lungs

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11
Q

What is symptoms of right heart failure?

A
  • Congestion in systemic venous system
  • Fatigue and weakness
  • Peripherial edema
  • Pitting edema in lower legs and ankles
  • Reduction in renal blood flow
  • Distended jugular vein
  • Edema in abdomen
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12
Q

what are the signs and symptoms of later stages of heart failure?

A
  • Mental confusion, anxiety and restlessness- lack of O2
  • Cardiac cachexia- wasting of tissues
  • Cyanosis
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13
Q

What are the treatment of Heart Failure?

A
  • lifestyle chanegs can lessen symptoms
  • Drug therapy: ACE inhibitors, diurectics, vasodilators, beta blockers, calcium channel blockers
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14
Q

What is the sign of heart failure in a dental setting?

A
  • Swelling in feet or ankles, Shortness of breath, weight gain- POSTPONE treatment
  • Cyanosis, Jugualr veins (Characterisitics observation)
  • Vitals prior to and during treatment
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15
Q

How to manage a PT with ASA II Classification?

A
  • Mild dyspnea and fatigue during excertion- may need 3-5 liters of supllemental oxygen
  • Chairs upright position
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16
Q

How to manage a PT with ASA III Classification

A

Require medical consultation
- orthopnea
- modification in patient poitioning
- supplemental oxygen

17
Q

How to manage a PT with ASA IV Classification

A

Elective treatment should be postpone until symptoms controlled

18
Q

What is acute pulmonary edema?

A

Sudden accumulation of excessive fluid in the lungs, because of left venticular heart failure
Most dramatic life threating symptom of left HF

19
Q

What are precipitating events of acute pulmonary edema?

A
  • Stress
  • Infection
  • Failure to take medications
  • Meal high in sodium
  • Inhibits lung expansion
  • Decreased ability of lungs to oxygenate blood
20
Q

What are the signs and symptoms of Acute pulmonary edema?

A
  • Gasping for air
  • Rapid Pulse
  • Cool, moist skin
  • Cyanotic lips and nail beds
  • Anxiety
  • Dyspnea with cough that may produce frothy blood
  • Loud coarse lunge sounds
21
Q

What are the treatment of acute pulmonary edema?

A
  • Focus on reduction of fluid in lungs
  • Sitting patient upright redirects blood to lower
  • Drug therapy
  • Oxygen
  • Severe cases needs intubated and ventilated mechanically in hospital
22
Q

What is the treatment for Acute Pulmonary Edema in a dental setting?

A
  • Contact EMS
  • Terminate all treatment
  • Reduce patient anxiety to reduce cardiac and respiratory workload
  • Position patient comfortably, upright
  • Compressions, Airway, Breathing (CAB)
  • O2 10 liters/minute or more
  • Monitor Vital signs
  • Nitroglycerine 2-3 tablets or spray 5-10 min
23
Q

If Pt systolic BP below 100mmHg what should you not do?

A

Do not adminsiters nitroglycerine