Medsurg Exam 1: Cardiovascular Disorders Flashcards
What side does Heart Failure (CHF) occur on?
Can be left sided / right sided and deals with the pump failing
What are the 4 contributions to Left Side HR
- Hypertension
- Coronary Artery Disease
- MI Cardinal Infractions
- Structure Heart Changes
How does Hypertension contribute to LS CHF?
Pumping out against high pressure
Heart that is already working hard and now its pumping against a close door with hypertension in arterioles
How does Coronary artery disease contribute to LS CHF?
if not perfusing the heart muscle, the heart is going to fail
Vessels that go around heart
Not enough circulation to heart itself
How does MI Cardinal Infractions contribute to LS CHF?
left sided heart failure = tissue damage
Trigger by hypertension
Infract a huge percentage of the heart, and involves a huge part of left
Area of infarction tissue, a huge part of the wall, the heart will balloon out and have no integrity to muscle, it is working against the heart
How does Structure Heart Changes contribute to LS CHF?
Valvular issues
Papillary muscle
Aortic or mitral valve issues
What is the result of LS CHF = Systolic Failure
THINK: FORWARD FLOW
Inadequate pumping (to get that forward flow needed) Not enough force, not enough full volume forward, increasing preload (blood in the atrium)
Preload = volume of blood that is left in the ventricle after contraction due to issues with not ejecting all the blood
If you have a lot of preload it is telling you that the heart isn’t getting it out
Increase afterload = increases peripheral vascular resistance
Arteriole system is compensating for it with increase afterload because they are clamping down to control the lack of blood
Volume low and CO low
Heart failure with an ejection fraction of less than 45 percent
Results of LS CHF on distolic Failure
THINK: Back up of blood
The left ventricle cannot relax
It is working so hard = leads to stiffness
Stiff = issues with filling properly
Left ventricle not relaxed = leads to back flow of blood into the lungs
What are the S/S of LHF
Decreased cardiac output
likely will hear a third heart sound (S3 tells you increased left ventricular pumping) and fourth heart sound (indicates decreased left ventricular compliance), fatigue
Pulmonary cardiac congestion = think the blood is going back into the lungs
tend to get crackles and frothy pink sputum due to the volume not going forward finding itself back in lungs, paranormal nocturnal dyspnea (PND)
What are the three main causes of RS CHF?
LVF
Right Ventricular MI
Pulmonary Hypertension
How does LVF cause RS CHF
usually seen when left side fails leads to right side failure → and the left side usually fails first BUT can make many excuses as to why right failed first
How does Right ventricular MI cause RS CHF
coronary artery disease and can lead to massive right sided MI which leads to decreased wall
How does Pulmonary Hypertension cause RS CHF
a pre existing condition, a right ventricular high afterload → think the right side of the heart has to push against the high pressure system that is the pulmonary tree
What are the results of RS CHF?
Cannot empty the right side ventricle fully
Increased volume in the systemic circulation (right side pumps to the lungs to oxygenate so if they can do this there will be increase in systemic)
S/S of RS CHF
Edema and weight gain = edema is the most directly observable Blood pressure (poor indicator since affected by so many things) JVD = backing up from right side GI and GU issues = increased thirst, oliguria during the day, anorexia and nausea, could see an enlarged spleen/ live
LOOK AT DAILEY WEIGHTS
