Patho Final Study Guide Flashcards
Right sided heart failure
leads to dependent edema, enlarged organs (liver or spleen), decreased appetite, or ascites.
Dependent edema: whatever part of the body is lowest. If lying flat could be peripheral edema. Is standing up could be peripheral lower extremity edema
Left sided heart failure
leads to pulmonary edema, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, fatigue, weakness, restlessness, anxiety, bronchospasms, or wheezing.
Advanced heart failure
may lead to Cheyne-Stokes respiration, sleep apnea, blood clot formation due to sluggish blood flow, depression, and/or declining mental function
Physical Exam of HF
crackles, wheezes, presence of S3 and S4, cyanosis, jugular venous distention, weight gain, edema
Serum analysis for people with HF?
CBC to look for anemia or infection as possible causes
Urinalysis for proteinuria which is associated with CV disease
Electrolytes for fluid retention or renal dysfunction
BUN/Creatinine for possible reduction in renal blood flow, look at them together, not just one or the other
Fasting blood sugar: elevated levels increase risk of heart failure
Liver function tests to evaluate liver function
Natriuretic peptide (B-type) increases in heart failure and are closely associated with NYHA classifications IMPORTANT TO KNOW: (normal values are less than 100 pg/mL)
Pharmacologic Meds for heart failure
may include any single or combination therapy of the following classification of drugs:
ACE inhibitors: interrupt conversion of angiotensin 1 to angiotensin 2, decreasing cardiac work and increasing cardiac output improving blood flow
Angiotensin 2-receptor blockers: block the action of angiotensin 2 with similar effects
Beta-blockers: block the beta receptors inhibiting the sympathetic nervous system slowing heart rate and lowering blood pressure. These may also reduce the force of contraction causing more problems, but when used with ACE inhibitors may improve outcomes.
Diuretics: relieve symptoms of fluid overload
Vasodilators: relax the smooth muscle of the vessels, reduce afterload, and reduce the work of the heart
Digitalis preparations: positive inotropic effect improving contractility, slows conduction and increases fill time of the ventricles.
Oxygen therapy: to promote adequate oxygenation.
It is important to note that treating and managing co-morbidities is also important in managing heart failure.
Oliguria
Oliguria is when urine output is lower than expected.
anuria
absent urine
syncope
fainting
phlebitis
pain, redness along the vein, discontinue IV, apply a warm compress
Atrial fibrillation, or AFib
occurs when many unstable electrical impulses misfire and may result in the atria quivering out of control.
Ventricular fibrillation:
can stop the heart from beating and cause cardiac arrest. It occurs in the ventricles, which are unable to pump blood out of your heart to the body and brain due to the irregular heartbeat.
beta 2 agaonis is for acute asthma attack and they all end In
-erol
what would we give with someone with hyperkalemia
kayexalate
- insulin
- sodium bicarbonate
- calcium gluconate
hypernatremia
too much sodium
What does the RAAS system do?
rennin and angiotensoin response to BP and causes vasoconstriction
-aldosterone hold onto sodium or water
treatment for hyponatremia
LR
or normal saline if they are NPR
Hypocalcemia
this the chvostek’s and trusseas
- tingling of the mouth is common
- risk of bleeding and fractures
- cardiac dysrhythmias
Hypercalcemia
"moans grons and stones" Administer biphosphonates - bone pain -severe muscle weakness -Decreased DTR -kidneys stones