PNP- Unit 2: Chapter 6- Heart Failure, Shock, Anemia Flashcards
What is Heart Failure?
➡ A clinical syndrome where the heart cannot pump sufficient blood to meet the metabolic demands of the body.
Compensatory Mechanisms in Heart Failure
✅ Vasoconstriction → Increases afterload, reduces cardiac output
✅ Sodium & Water Retention → Increases preload, leading to excessive stretch, weak contractions
✅ Tachycardia → Reduces diastolic filling, decreasing stroke volume
🔴 Left-Sided Heart Failure (LHF) – Causes
Back:
➡ Hypertension
➡ Coronary Artery Disease
➡ Valvular Disease
➡ Cardiomyopathy
Left-Sided Heart Failure – Symptoms
➡ Pulmonary congestion (crackles, dyspnea, tachypnea)
➡ Cough (dry at first, later pink frothy sputum)
➡ Fatigue, weakness, confusion
➡ Orthopnea (SOB while lying down)
Right-Sided Heart Failure (RHF) – Causes
➡ Left-sided HF
➡ Pulmonary Hypertension
➡ Lung disease
Right-Sided Heart Failure – Symptoms
➡ Peripheral edema (feet, legs, sacrum)
➡ Jugular vein distention (JVD)
➡ Ascites, hepatomegaly, splenomegaly
➡ Weight gain, nausea, anorexia
What is Shock?
➡ Life-threatening condition due to imbalance between oxygen supply and demand at the cellular level
➡ Leads to hypoperfusion and impaired oxygenation
Types of Shock
✅ 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)
Stages of Shock
1️⃣ Compensatory Stage → BP maintained by SNS, increased HR
2️⃣ Progressive Stage → Hypotension, lactic acidosis, organ dysfunction
3️⃣ Irreversible Stage → Multi-organ failure, death
What is Anemia?
A deficit of RBCs → Low oxygen-carrying capacity → Tissue hypoxia
Opposite of Anemia?
Polycythemia → Too many RBCs → Increased blood viscosity
Symptoms of Anemia
➡ Mild → No symptoms or fatigue
➡ Moderate → Weakness, tachycardia, exertional dyspnea
➡ Severe → Hypotension, pallor, heart failure, dizziness
Types of Anemia
✅ Aplastic Anemia → Bone marrow disorder, pancytopenia
✅ Vitamin B12/Folate Deficiency → Megaloblastic anemia, neurological symptoms
✅ Iron Deficiency Anemia → Microcytic, hypochromic RBCs (PICA craving)
Systolic vs. Diastolic Heart Failure
Systolic Dysfunction:
➡ Weakened heart muscle, poor contraction
➡ Less blood ejected → Reduced cardiac output
diastolic heart failure
✅ Diastolic Dysfunction (HFpEF):
Ventricles stiff, less filling
➡ Decreased stroke volume
Signs of Left-Sided Heart Failure
➡ 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)
Signs of Right-Sided Heart Failure
➡ 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)
Heart Failure Management – First-Line Treatment
✅ 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
Ejection Fraction (EF) – What is it?
➡ The percentage of blood ejected from the left ventricle per beat
Complications of Heart Failure
➡ 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)
What is Cardiogenic Shock?
Common Cause?
a life-threatening condition that occurs when the heart can’t pump enough blood to the body
Common cause: Myocardial infarction (MI)
Symptoms of Cardiogenic Shock
✅ Hypotension
✅ Cold, clammy skin
✅ Tachycardia, weak pulses
✅ Decreased urine output
✅ Altered mental status (low brain perfusion)
What is Hypovolemic Shock?
Causes?
➡ Low blood volume → Decreased cardiac output & perfusion
➡ Causes: Hemorrhage, burns, dehydration
Symptoms of Hypovolemic Shock?
✅ Hypotension
✅ Tachycardia, weak thready pulse
✅ Cool, pale skin
✅ Decreased urine output (oliguria)
✅ Altered mental status
Distributive Shock Types – What’s the Difference?
✅ 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
Iron Deficiency Anemia – Key Features
✅ Blood loss (GI bleed, heavy menstruation)
✅ Low iron intake (dietary deficiency)
✅ Increased demand (pregnancy, growth spurt)
Anemia symptoms
✅ Pallor, fatigue, weakness
✅ Glossitis (inflamed tongue)
✅ PICA (craving for non-food items like ice, dirt)
Pernicious Anemia
Vitamin B12 Deficiency
Sickle Cell Anemia – What Happens?
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
S & S of Right -Sided Heart Failure- Backward Effects
-Hepatomegaly
-Ascites
-Splenomegaly
-Anorexia
-Subcutaneous edeme
-Jugular vein distention
Daily Monitoring for Heart Failure Patients – What’s Most Important?
✅ 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
Meds for heart failure patients
✅ Medication adherence:
➡ Diuretics, ACE inhibitors, beta-blockers
Left Sided SS
- Back flow and pooling in lungs
Right Sided Heart Failure
- Pools in abdomen
CHF Treatment
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.
S & S of Left Sided Heart Failure
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
S &S of Right Sided HF
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
