PNP- Unit 2: Chapter 6- Heart Failure, Shock, Anemia

Question 1

What is Heart Failure?

Answer 1

➡ A clinical syndrome where the heart cannot pump sufficient blood to meet the metabolic demands of the body.

Question 2

Compensatory Mechanisms in Heart Failure

Answer 2

✅ Vasoconstriction → Increases afterload, reduces cardiac output
✅ Sodium & Water Retention → Increases preload, leading to excessive stretch, weak contractions
✅ Tachycardia → Reduces diastolic filling, decreasing stroke volume

Question 3

🔴 Left-Sided Heart Failure (LHF) – Causes

Answer 3

Back:
➡ Hypertension
➡ Coronary Artery Disease
➡ Valvular Disease
➡ Cardiomyopathy

Question 4

Left-Sided Heart Failure – Symptoms

Answer 4

➡ Pulmonary congestion (crackles, dyspnea, tachypnea)
➡ Cough (dry at first, later pink frothy sputum)
➡ Fatigue, weakness, confusion
➡ Orthopnea (SOB while lying down)

Question 5

Right-Sided Heart Failure (RHF) – Causes

Answer 5

➡ Left-sided HF
➡ Pulmonary Hypertension
➡ Lung disease

Question 6

Right-Sided Heart Failure – Symptoms

Answer 6

➡ Peripheral edema (feet, legs, sacrum)
➡ Jugular vein distention (JVD)
➡ Ascites, hepatomegaly, splenomegaly
➡ Weight gain, nausea, anorexia

Question 7

What is Shock?

Answer 7

➡ Life-threatening condition due to imbalance between oxygen supply and demand at the cellular level
➡ Leads to hypoperfusion and impaired oxygenation

Question 8

Types of Shock

Answer 8

✅ Cardiogenic Shock → Pump failure (MI, heart dysfunction)
✅ Obstructive Shock → Blockage (PE, tamponade)
✅ Hypovolemic Shock → Low blood volume (hemorrhage, burns)
✅ Distributive Shock → Widespread vasodilation

Anaphylactic Shock (allergic reaction)
Neurogenic Shock (loss of SNS tone)
Septic Shock (infection-induced vasodilation)

Question 9

Stages of Shock

Answer 9

1️⃣ Compensatory Stage → BP maintained by SNS, increased HR
2️⃣ Progressive Stage → Hypotension, lactic acidosis, organ dysfunction
3️⃣ Irreversible Stage → Multi-organ failure, death

Question 10

What is Anemia?

Answer 10

A deficit of RBCs → Low oxygen-carrying capacity → Tissue hypoxia

Question 11

Opposite of Anemia?

Answer 11

Polycythemia → Too many RBCs → Increased blood viscosity

Question 12

Symptoms of Anemia

Answer 12

➡ Mild → No symptoms or fatigue
➡ Moderate → Weakness, tachycardia, exertional dyspnea
➡ Severe → Hypotension, pallor, heart failure, dizziness

Question 13

Types of Anemia

Answer 13

✅ Aplastic Anemia → Bone marrow disorder, pancytopenia

✅ Vitamin B12/Folate Deficiency → Megaloblastic anemia, neurological symptoms

✅ Iron Deficiency Anemia → Microcytic, hypochromic RBCs (PICA craving)

Question 14

Systolic vs. Diastolic Heart Failure

Answer 14

Systolic Dysfunction:

➡ Weakened heart muscle, poor contraction

➡ Less blood ejected → Reduced cardiac output

Question 15

diastolic heart failure

Answer 15

✅ Diastolic Dysfunction (HFpEF):

Ventricles stiff, less filling

➡ Decreased stroke volume

Question 16

Signs of Left-Sided Heart Failure

Answer 16

➡ Pulmonary congestion (crackles, cough, dyspnea)

➡ Pink frothy sputum (severe cases – pulmonary edema)

➡ Tachycardia, S3 gallop (early sign of HF)

➡ Orthopnea, PND (paroxysmal nocturnal dyspnea)

➡ Fatigue, confusion (low CO)

Question 17

Signs of Right-Sided Heart Failure

Answer 17

➡ Peripheral edema (dependent edema, legs, sacrum, hands, abdomen)

➡ Jugular vein distension (JVD)

➡ Hepatomegaly, ascites, GI distress (nausea, anorexia)

➡ Weight gain (fluid retention – daily weight monitoring!)

➡ Nocturia (fluid shift when lying down)

Question 18

Heart Failure Management – First-Line Treatment

Answer 18

✅ ACE Inhibitors (-prils) → Vasodilation, reduces afterload & preload

✅ Beta-Blockers (-lols) → Decrease HR, reduce workload

✅ Diuretics (Furosemide, Spironolactone) → Reduce fluid overload

✅ Digoxin (in select patients) → Increases contractility, lowers HR

Question 19

Ejection Fraction (EF) – What is it?

Answer 19

➡ The percentage of blood ejected from the left ventricle per beat

Question 20

Complications of Heart Failure

Answer 20

➡ Pulmonary edema (fluid in lungs – pink frothy sputum, severe dyspnea)

➡ Renal failure (low perfusion, low urine output)

➡ Arrhythmias (Atrial fibrillation, V-tach)

➡ Cardiogenic shock (end-stage HF, low CO, hypotension)

Question 21

What is Cardiogenic Shock?

Common Cause?

Answer 21

a life-threatening condition that occurs when the heart can’t pump enough blood to the body

Common cause: Myocardial infarction (MI)

Question 22

Symptoms of Cardiogenic Shock

Answer 22

✅ Hypotension
✅ Cold, clammy skin
✅ Tachycardia, weak pulses
✅ Decreased urine output
✅ Altered mental status (low brain perfusion)

Question 23

What is Hypovolemic Shock?

Causes?

Answer 23

➡ Low blood volume → Decreased cardiac output & perfusion

➡ Causes: Hemorrhage, burns, dehydration

Question 24

Symptoms of Hypovolemic Shock?

Answer 24

✅ Hypotension
✅ Tachycardia, weak thready pulse
✅ Cool, pale skin
✅ Decreased urine output (oliguria)
✅ Altered mental status

Question 25

Distributive Shock Types – What’s the Difference?

Answer 25

✅ Septic Shock – Systemic infection → Widespread vasodilation, hypotension ✅ Anaphylactic Shock – Severe allergic reaction → Histamine release → Vasodilation, bronchoconstriction ✅ Neurogenic Shock – Spinal cord injury or trauma → Loss of SNS tone, bradycardia, hypotension

Question 26

Iron Deficiency Anemia – Key Features

Answer 26

✅ Blood loss (GI bleed, heavy menstruation) ✅ Low iron intake (dietary deficiency) ✅ Increased demand (pregnancy, growth spurt)

Question 27

Anemia symptoms

Answer 27

✅ Pallor, fatigue, weakness ✅ Glossitis (inflamed tongue) ✅ PICA (craving for non-food items like ice, dirt)

Question 28

Pernicious Anemia

Answer 28

Vitamin B12 Deficiency

Question 29

Sickle Cell Anemia – What Happens?

Answer 29

Genetic disorder where RBCs become sickle-shaped Sickle cells that block blood flow to organs deprive the affected organs of blood and oxygen. In sickle cell anemia, blood also is low in oxygen

Question 30

S & S of Right -Sided Heart Failure- Backward Effects

Answer 30

-Hepatomegaly -Ascites -Splenomegaly -Anorexia -Subcutaneous edeme -Jugular vein distention

Question 31

Daily Monitoring for Heart Failure Patients – What’s Most Important?

Answer 31

✅ Daily Weights! ➡ Sudden weight gain (>2-3 lbs in 1 day or >5 lbs in a week = fluid overload! ✅ Monitor for worsening symptoms: ➡ Increased dyspnea, edema, fatigue, orthopnea ✅ Diet: ➡ Low sodium, fluid restriction if prescribed

Question 31

Meds for heart failure patients

Answer 31

✅ Medication adherence: ➡ Diuretics, ACE inhibitors, beta-blockers

Question 32

Left Sided SS

Answer 32

- Back flow and pooling in lungs

Question 33

Right Sided Heart Failure

Answer 33

- Pools in abdomen

Question 34

CHF Treatment

Answer 34

Vasodilators: medications that widen blood vessels, which helps lower blood pressure and improve heart function. They are used to treat high blood pressure, heart failure, and other conditions. Diuretics: a class of drugs that increase urine production. They help the body get rid of excess salt and water.

Question 35

S & S of Left Sided Heart Failure

Answer 35

Left-sided heart failure affects the lungs, while right-sided heart failure affects the rest of the body. Shortness of breath, especially when lying down Coughing, especially during exertion Fatigue Weakness, especially in the legs Kidney problems or increased nighttime urination Increased heart rate

Question 36

S &S of Right Sided HF

Answer 36

Fluid retention and swelling, especially in the lower body Weight gain Heart palpitations Chest discomfort Shortness of breath, especially when lying down Blood backing up in the body's veins Fluid buildup in the vessels leading to the heart