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MS exam 2 (final) > 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
SNS compensation
fight or flight increases CO by increasing HR and BP counterproductive long term, increases oxygen demand on already weak heart
26
dilation structural changes
increased preload and stroke volume causes more forceful contractions muscle fibers in ventricles overstretch like a rubberband related to HFrEF
27
hypertrophy structural changes
heart muscle is so thick the blood has no room prone to dysrhythmias - poor contractility - deformity occurs related to HFpEF
28
ANP and BNP
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
increase BNP levels mean?
fluid retention and predicts mortality in HF pts
30
normal BNP
less than 100
31
mild BNP
greater than 300
32
moderate BNP
greater than 600
33
severe BNP
greater than 900
34
nitric oxide and prostaglandin use
causes vasodilation and decrease the afterload
35
s/s acute decompensated HF
tachypnea decreased O2 SOB pulmonary edema crackles/wheezing bloody frothy sputum anxious, pale, cyanotic cool/clammy
36
s/s chronic HF
fatigue dyspnea edema nocturia chest pain weight changes tachycardia
37
diagnostic tests for HF
BNP xray ekg echocardiogram cardiac cath TEE
38
cardiac cath
invasive, groin large artery check for contrast sensitivity NPO 6-12hrs before
39
cardiac cath metformin use
pt must stop med 24-48hrs pre op and post op assess extremity uses and injection site cardiac monitoring & vitals
40
echocardiogram or TEE
shows EF and heart function
41
TEE
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
what does an xray show
hypertrophy and congestion
43
what does an EKG show
hypertrophy
44
complications of HF
pleural effusion(cough, dyspnea, chest pain) dysrhythmias hepatomegaly cardiorenal syndrome anemia a-fib sodium & water retention
45
primary prevention of HF
manage hypertension regular visits with PCP up to date w vax
46
secondary screenings of HF
ekg echo cardiac cath xray bnp TEE stress test
47
treatment for acute decompensated HF
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
treatment of chronic HF
treat underlying factors maximize CO O2 first line med is ACE inhibitors

MS exam 2 (final) (9 decks)

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