Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N232 > Module 4 Part 4 Heart Failure > Flashcards

Module 4 Part 4 Heart Failure Flashcards

1
Q

what is preload? and what is the greatest determinant?

A
  • ‘the degree to which myocardial fibers are stretched at the end of diastole…just before systole’
  • greatest determinant is venous blood return to heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is afterload? and what is the greatest determinant?

A
  • resistance in aorta that the heart has to pump its volume against
  • greatest determinant is peripheral arterial vasoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is contractility?

A

contractile strength of the heart pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what happens with the blood in R sided heart failure?

A
  • back up of blood to body

- decreased blood in lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happens with the blood in L sides HF?

A

-dec. of blood to body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

mnfts of L sided HF (9)

A
  • dyspnea
  • elevated pulmonary capillary wedge pressure
  • pulmonary congestion: cough, crackles, wheezes, tachypnea, blood-tinged sputum
  • restlessness
  • confusion
  • orthopnea
  • tachycardia
  • fatigue
  • cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

mnfts of R sided HF (8)

A
  • fatigue
  • inc. peripheral venous pressure
  • ascites
  • enlarged liver and spleen
  • distended jugular veins
  • anorexia and complaints of GI distress
  • weight gain
  • edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

modifiable risk factors for HF (6)

A
  • ischemic heart disease
  • HTN
  • diabetes
  • metabolic syndrome
  • hyperlipidemia
  • smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the overall goals of HF management?

A 
-ELIMINATE OR REDUCE CONTRIBUTORY
FACTORS
-REDUCE WORKLOAD ON THE HEART (prelaod/afterload)
-OPTIMIZE ALL THERAPEUTIC REGIMENS
-PREVENT EXACERBATIONS OF HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

drugs for L sided HF

A
  • diuretics
  • ACE inhibitors
  • angiotensin 2 receptor blockers
  • direct vasodilators
  • beta blockers
  • cardiac glycosides (digoxin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do preload reducer drugs do?

A

Reduce myocardial workload by reducing the amount of volume coming back to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the worst thing that could happen if someone takes a preload reducer drug?

A
  • inadequate cardiac output by pooling of blood in extremities
  • hypotension (orthostatic)/dehydration
  • electrolyte imbalance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2 examples of preload reducer drug classifications?

A

-diuretics, vasodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what do afterload reducer drugs do?

A

Reduce myocardial workload by decreasing the resistance that the heart has to pump against

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the worst thing that could happen if someone takes a afterload reducer drug?

A
  • hypotension, hypovolemia, hyperkalemia

- aggravated heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

examples of afterload reducer drug classifications?

A

ace inhibitors, angiotensin 2 blockers, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what do contractility (& afterload) reducers drugs do?

A
  • reduce myocardial workload by reducing contractile force

- reduce myocardial workload by reducing after load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the worst thing that could happen if someone takes a contractility (& afterload) drug?

A

inadequate CO from reduced contractility

19
Q

examples of contractility (& afterload) drug classifications?

A

-extended release of beta blockers only*: carvedilol and metoprolol b/c of their afterload reduction properties

20
Q

what do positive inotrope drugs do?

A

increase the contractile force of the myocardium and slow HR

21
Q

what is the worst thing that could happen if someone takes a positive inotrope drug?

A

-increase myocardial workload by increasing oxygen demands, digoxin toxicity (digoxin levels!!!)

22
Q

example of a class for positive inotropes?

A

cardiac glycosides (digoxin)

23
Q

what Dx would you want for HF (8)

A

-chest xray
-echo (ejection fraction)
-ECG
-angiogram
-BNP
-CBC and renal Fx
-Na and K (electrolytes)
digoxin therapeutic levels

24
Q

what lab values would you be interested in for HF?

A
  • CBC
  • electrolytes
  • GFR, creatinine
  • digoxin level
  • BNP
25
Q

what is BNP?

A

Brain Natriuetic Peptide- LAB

  • secreted by the ventricles in response to excessive stretching of cardiac muscle cells
  • WILL BE POSITIVE IF THERE’S HF
26
Q

what are the two actions of BNP?

A
  • actions include:
    1. dec. in systemic vascular resistance and central venous pressure
    2. increase in natriuresis: the process of excretion of Na in urine via the kidneys
27
Q

whats a nutritional intervention for people with HF?

A 
DASH diet (DIETARY APPROACHES TO STOP HTN)
-reducing sodium in diet reduces fluid retention and decreases circulating BV
28
Q

how is fluid volume managed? (6)

A
  • diuretic therapy
  • daily weight
  • fluid restrictions (ins/outs)
  • respiratory assessment
  • positional to reduce pre-load
  • assessing skin for breakdown
29
Q

what is nursing mngmt for activity intolerance?

A
  • rest

- individualized period of daily exercise gradually increasing in duration

30
Q

what is nursing mngmt for SOB?

A
  • supplemental oxygen; monitor O2 sats
  • for SOBOE, have pt rest, raise HOB
  • complete respiratory assessment
31
Q

what is nursing management for controlling anxiety?

A
  • admin o2 if reqd
  • promote physical comfort and psychological support
  • relaxation techniques
  • screen for depression
32
Q

what is nursing management for impaired sleep?

A
  • providing reqd pillows for ease of breathing

- provider chair for pt if they cannot get comfortable in bed

33
Q

what is a crystalloid fluid?

A

aqueous solution of mineral salts and other small, water-soluble molecules

34
Q

why would you administer crystalloids?

A

they contain electrolytes so they increase circulatory volume without altering chemical balances in the vascular spaces

35
Q

what are the negative side effects of crystalloids?

A

electrolyte balance, coagulation, liver and kidney function

36
Q

what is a colloid fluid?

A

-homogeneous noncrystalline substance consisting of large molecules dispersed through a second substance

37
Q

why would you administer colloids?

A

restores the intravascular volume with minimal risk of tissue edema in comparison with crystalloid solutions alone

38
Q

what are the negative side effects of colloids?

A

Intravascular volume overload, dilutional coagulopathy, extravascular extravasation across leaky capillary membranes, and anaphylactoid reactions

39
Q

what is heart failure?

A

the inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients

40
Q

in the past, what was heart failure often referred to as? and why?

A

often referred to as congestive heart failure because many patients experience pulmonary or peripheral congestion

41
Q

what is HF characterized by?

A

characterized by S+S of fluid overload or of inadequate tissue perfusion

42
Q

what occurs with left sided HF (pulmonary congestion)?

A

when the left ventricle cannot effectively pump blood out of ventricle into the aorta and systemic circulation

43
Q

what occurs with R sided HF?

A

there is congestion in the peripheral tissues and the viscera predominates

N232 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions