Special cardiac conditions Flashcards
This complication is defined as the inability of the heart to pump enough CO to meet the tissue’s O2 demands, which results in inadequate peripheral tissue perfusion
Heart Failure
Name 5 underlying conditions that cause HF
ischemia heart disease, MI, cardiomyopathy, valvular heart disease, and hypertension
of people with HF in US
5.8 million
HF is accountable for how many hospitalizations a year and how many hospital days
1 million, 6.5 million days
True or False, HF is a disease
False, HF is a complication of cardiac and non cardiac abnormalities
What is hospitalized heart failure (HHF)
new onset or worsening signs and symptoms that require urgent therapy and hospitalization
Non cardiac precipitation factors of AHF include
COPD and pneumonia, non adherence to therapeutic regimen, infection, ETOH, diabetes, surgery
Two dysfunction types of HF include
systolic and diastolic failure
Systolic HF
leads to problems with contraction and ejection of blood resulting in increased system vascular resistance. Increased SVR causes increase in afterload.Also reduced EF
Diastolic HF
stiff myocardium doesn?t allow left ventricle to fill up with blood which leads to increased pressure in left atrium and pulmonary vasculature. Preserved EF
Signs of left-sided heart failure
pulmonary congestion, dyspnea, tachypnea, crackles, dry cough, paroxysmal nocturnal dyspnea, increase BP form fluid excess or decreased BP from pump failure
LEFT sided heart failure FORWARD failure) description
Results in PULMONARY congestion due to the inability of the LEFT ventricle to pump blood to the periphery.
Symptoms of left sided failure include
SOB, dyspnea on exertion, paroxysmal noctural dyspnea, orthopnea, pulmonary edema, dry & unproductive cough that occurs mostly at night, tachycardia, fatigue, anxiety, restlessness, confusion, tachycardia S3 ventricular gallop
RIGHT sided failure ( BACKWARD failure) description
results in PERIPHERAL congestion due to the inability of the RIGHT ventricle to pump blood out to the lungs; often results due from left-sided failure or pulmonary disease
Symptoms of RIGHT sided failure
edema in ankles, unexplained weight gain, abdominal pain assoc. with liver congestion, JVD, abnormal fluid in body cavities (pleural space, abd. Cavity), anorexia and nausea assoc. w/ hepatic and visceral engorgement, nocturia, weakness
How many pounds must you gain to have pitting edema?
10 lbs or 4.5kg of fluid
Pneumonic to remember the difference between left and right sided HF
Right= Rest of the body. Left = Lungs
Ejection fraction
Measurement of volume of blood pushed out by ventricles seen on an echo. Normal 55-60%. < 40 =HF or cardiomyopathy. > 75= hypertrophic cardiomyopathy
Treatment for HF
treat reversible cause, heart transplant, drugs, cardiac resynchronization therapy
Drugs used to treat HF include
digitalis, diuretics, ace inhibitors of beta blockers
2 common digitalis
digitoxin and digoxin
Indications and actions of digitalis
HF. Increases the contractility of cardiac muscle and slows HR and conduction by blocking Na/K atpase converting to Ca++.
Digitalis neurohormonal control decreases what 3 things and increases what 1 thing.
decreases plasma noradrenaline, peripheral nervous system activity, and RAAS activity, and increases vagal tone
Nursing implications for digitalis
check apical pulse prior to administration. Call provider if HR< 60 or > 120 bpm or has a markedly changed rhythm
