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MS exam 2 > perfusion/heart failure > Flashcards

perfusion/heart failure Flashcards

1
Q

what is heart failure?

A

blood keeps backing up because heart cant provide enough blood to meet O2 needs

CO & strove volume are decreased

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2
Q

primary risk factors of heart failure

A

coronary artery disease
hypertension
diabetes mellitus
advanced age, tobacco use

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3
Q

warning signs of heart failure

A

F atigue
A ctivity intolerance
C hest congestion
E dema
S hortness of breath

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4
Q

ejection fraction

A

% of blood pumped out per heart beat

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5
Q

normal ejection fraction

A

50-75%

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6
Q

heart failure ejection fraction

A

less than 50%

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7
Q

severe heart failure ejection fraction

A

less than 40%

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8
Q

right sided heart failure

A

REST of the body - blood backs up into venous system

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9
Q

s/s of right sided heart failure

A

JVD
peripheral edema
ascites
hepatomegaly
splenomegaly
fluid retention
nocturia

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10
Q

causes of right sided heart failure

A

left sided heart failure
MI
pulmonary embolism
COPD

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11
Q

left sided heart failure

A

affects the LUNGS

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12
Q

s/s left sided heart failure

A

crackles/wheezing
orthopnea
tachy
dyspnea
blood-tinged frothy sputum
tachypnea
nocturnal dyspnea

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13
Q

causes of left sided heart failure

A

MI
hypertension
coronary artery disease

left ventricle cant empty during systole or fill during diastole
heart is too stiff

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14
Q

systolic HFrEF

A

reduced ejection fraction
under 40%

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15
Q

HFrEF s/s

A

EF under 40%
pallor
cool extremities
tachypnea
nocturia

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16
Q

causes of HFrEFF

A

MI
hypertension

ventricles are stretched

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17
Q

diastolic HFpEF

A

preserved ejection fraction

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18
Q

s/s HFpEF

A

diastolic # is high (vessels arent resting)

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19
Q

causes of HFpEF

A

hypertension
older age
females
diabetes
obesity

left ventricle is too stiff& hypertrophied to fill correctly

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20
Q

RAAS system

A

tries to raise BP by retaining fluid& sodium and vasoconstricting

21
Q

RAAS meds/hormones

A

renin
angiotensionogen
angiotension 1+2
ACE
aldosterone
ADH

22
Q

what does angiotension 2 do?

A

increases BP increases HR

23
Q

what does aldosterone do?

A

retains sodium and water
causes vasoconstriction (raises BP)

24
Q

what does ADH do?

A

causes water reabsorption

25
Q

SNS compensation

A

fight or flight
increases CO by increasing HR and BP

counterproductive long term, increases oxygen demand on already weak heart

26
Q

dilation structural changes

A

increased preload and stroke volume causes more forceful contractions
muscle fibers in ventricles overstretch like a rubberband
related to HFrEF

27
Q

hypertrophy structural changes

A

heart muscle is so thick the blood has no room
prone to dysrhythmias - poor contractility - deformity occurs
related to HFpEF

28
Q

ANP and BNP

A

produced by heart when there is increased blood in the heart due to ventricular stretching

attempt to counter negative effects of SNS and RAAS

29
Q

increase BNP levels mean?

A

fluid retention and predicts mortality in HF pts

30
Q

normal BNP

A

less than 100

31
Q

mild BNP

A

greater than 300

32
Q

moderate BNP

A

greater than 600

33
Q

severe BNP

A

greater than 900

34
Q

nitric oxide and prostaglandin use

A

causes vasodilation and decrease the afterload

35
Q

s/s acute decompensated HF

A

tachypnea
decreased O2
SOB
pulmonary edema
crackles/wheezing
bloody frothy sputum
anxious, pale, cyanotic
cool/clammy

36
Q

s/s chronic HF

A

fatigue
dyspnea
edema
nocturia
chest pain
weight changes
tachycardia

37
Q

diagnostic tests for HF

A

BNP
xray
ekg
echocardiogram
cardiac cath
TEE

38
Q

cardiac cath

A

invasive, groin large artery
check for contrast sensitivity

NPO 6-12hrs before

39
Q

cardiac cath metformin use

A

pt must stop med 24-48hrs pre op and post op
assess extremity uses and injection site
cardiac monitoring & vitals

40
Q

echocardiogram or TEE

A

shows EF and heart function

41
Q

TEE

A

shows video of heart

pt must be NPO 6hrs post op
IV sedation
bite block in mouth
monitor vitals
suction as needed
cant eat or drink till gag is back

42
Q

what does an xray show

A

hypertrophy and congestion

43
Q

what does an EKG show

A

hypertrophy

44
Q

complications of HF

A

pleural effusion(cough, dyspnea, chest pain)
dysrhythmias
hepatomegaly
cardiorenal syndrome
anemia
a-fib
sodium & water retention

45
Q

primary prevention of HF

A

manage hypertension
regular visits with PCP
up to date w vax

46
Q

secondary screenings of HF

A

ekg
echo
cardiac cath
xray
bnp
TEE
stress test

47
Q

treatment for acute decompensated HF

A

U pright position
N itrates (drops BP)
L asix (watch K lvls)
O xygen
A ce inhibitors
D ogoxin/dopamine

M orphine (hold w low BP)
E

48
Q

treatment of chronic HF

A

treat underlying factors
maximize CO
O2
first line med is ACE inhibitors

MS exam 2 (9 decks)

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