Patho Perfusion Test #4 Flashcards
how many stages of heart failure are there?
4 classes
one being no limitations
two no limitations but symptoms with activity
three symptoms get worse
four symptoms are shown with no physical activity
how can heart failure be prevented?
- physical activity to make heart muscle stronger
- avoid smoking and drugs
- manage weight
- managing co-morbidites
- heart healthy eating ( low sodium avoid red meat)
what does the frank starling show?
I is a graph that shows the amount of stretch in the heart muscles
what happens when the neuroendocrine system is stimulated Sympathetic NS?
stimulate HR and BP
renogcingitension system
has to do with the fluid and sodium
What can cause heart failure?
- coronary artery disease
- increased work load
- impaired function
- non cardiac condition ( volume overload, fever, her thyroid, lung disease)
what are the causes of systolic heart failure?
coronary artery disease, myocarditis, chemotherapy, valve disorders, arrhythmias, pulmonary hypertension, hypo/hyper tension, renal failure, anemia
what are the causes of Diastolic heart failure?
Diabetes and hypertension
systolic dysfunction = enlarged ventricles less blood going out to body
Diastolic dysfunction = stiff ventricals less blood coming into the heart
clinical manifestations of heart failure
- orthopnea (shortness of breath that occurs when lying flat)
- dyspnea (difficult and labored breathing)
- edema
- fatigue
- symptoms of target organs
what symptoms can we see with Right-sided heart failure? (not able to push into pulmonary systems)
- dependent edema
- enlarged organs
- increased appitite
what symptoms can we see with left-sided heart failure?
heart cannot pump into peripheries so it backs up into lungs
- pulmonary edema
- dyspnea
- orthopnea
- nocturnal dyspnea
- bronchospasms
- wheezing
advanced heart failure can lead to what?
- blood clot formation
- Cheyne–Stokes respiration
- decline in mental function
- Depression
- sleep apnea
what are the complications of heart failure
- kidney / Liver damage or failure
- heart valve insufficiency
- Arrhythmias
what are some things we would look for as a nurse with heart failure?
- wheezes
- capillary refill prolonged
- check for s3 or s4 sounds
- is there jugular venous distention ( sign of backflow)
- cynotic
- weight gain
- edema
Diagnostic tests for HF? what would we see
protein uria in urine
- BUN and creatine check for filtering
- fasting Blood sugar will go up
- Liver Function test
- *-natriuretic peptide B type will be high (>100) this tells you how well HF is managed ** she made this seem important
- ECG
- Echocardiography can see the heart wall and valve movements
- xrays can see the heart and lungs
- CK tells you muscle death
nonpharm ways to treat heart failure
DASH diet ( low cholesterol/fat/sodium)
stop smoking
exercise 4-5 days 30 min a week
procedures to treat heart failure
surgery
pacing: biventricular pacing synchronizing therapy that sends electrical impulse to pump both sides at the same time
pharmacologic treatment for heart failure
ACE inhibitors - decresae cardiac workload and
increase output
ARBS - decresae cardiac workload and
increase output
Beta blockers inhibit sympathetic NS and decrease
BP
Diuretics
Vasodilators
Digelous Digoxin slows and helps with
contractility
o2 therapy
Thombotic Stroke
narrowing of the artery by fatty deposits called plaques.
plaque can cause a clot to form, blocks the passage of blood through the artery.
Embolic Stroke
An embolus is a blood clot or other debris circulating in the blood. when it reachs an artery in the brain that is too narrow to pass through, it lodges there and blocks the flow.
Hemorrhagic stroke
A burst in the blood vessel may allow blood to seep into and damage brain tissue, until clotting shuts off the leak
What are some modifiable risk factors for stroke?
- Hypertension
- Hypertension
- heart disease
- coagulation disorder
- alcohol use disorder
- smoking
- Diabetes
- Carotied artery disease
- obestity
- cocain use
What are some nonmodifiable risk factors for stroke?
- age
- gender
- race
- Heredity
True or false
Sleep apnea increases blood pressure and puts a person at higher risk of stroke
true
If the right side of the body is effected during a stoke what side of the brain was effected?
left side of the brain
what are the common S/S of left brain damage?
- impaired speech/langage aphasias
- slow performance, cautions
what are the common S/S of Right brain damage?
- tends to deny or minimize problems
- rapid performance short attention span
- impulsive, safety problems
- impaired judgement and time concepts
Complications of stroke (CVA)
pneumonia UTI seizures clinical depression pressure ulcers contractures DVT
Diagnosing Strokes
Careful health history is important to understand when the symptoms begin
Imaging
can show the part of the
brain that is effected
CT scan,
MRI can see stroke or nonstroke
angiography allows us to see the areas of vascular abnormalities
CVA (stroke) treatment non pharm
Prevention is key
- rehab to bring the ADLs as back to normal as we can
CVA (stroke) treatment pharm
- Antiplatelets agents (usually warfarin)
- managing hypertension
- controlling cholesterol levels
What cell would be found in Hodgkin lymphoma?
a postive a reed/sternberg cell or restinberg cell
high grade tumor is bad and more aggressive T/F
T
types of anxiety disorders
agoraphobia, panic disorder, specific phobia, generalized anxiety disorder
What neurotransmitter is believed to be dysfunctional in anxiety disorders
GABA
Mood disorders is (serotoin)
What is the treatment of panic disorder?
cognitive- behavioral therapy
deep
Glaucoma?
increased intraocular pressure, thicking of acuous humor
open-angle glaucoma is the most common form it is gradually progressive
