T1 Blueprint - HF (Josh) Flashcards
Which side heart failures is a.k.a CHF?
Left Side
What is the most common type of Left Side Heart Failure?
Systolic
- enlarged ventricles fill with blood and pump out less than 40-50% of the blood
Which type of Left Side HF is less common and associated with a filling problem?
Diastolic
***Stiff ventricle will fill with less blood than normal
Why would HF lead to Oliguria?
failure to perfuse the kidneys
Which heart sound is associated with Left Side HF?
S3
What drugs can be given to reduce AFTERLOAD?
ACE Inhibitors (-pril)
ARB (-sartan)
Human B-type Natriuretic Peptides (nesiritide)
What drugs can be given to reduce PRELOAD?
Morphine Sulphate
Diuretics (most common)
Venous dilators
- Nitrates
- Isosorbide
What drugs can be given to increase CONTRACTILITY?
Digoxin
Inotropics
- Dobutamine
- Milirinone (acute)
Beta Blockers (-lol)
Nursing action for PE
High Fowler’s
O2
Nitroglycerin
Rapid-acting diuretics
IV Morphine Sulfate
What medication can be given to deal with acute rejection of heart transplant?
Methylprednisolone IV
Long-term complications from Heart Transplant?
Denervated heart
Chronic Immunosuppression
- osteoporosis
- fragile skin
- obesity
- HTN
- Liver disease
- Kidney disease
What are the hemodynamic effects of Mitral Stenosis?
decrease forward flow and incomplete atrial empthying
What are the consequences of Mitral Stenosis?
Right ventricular hypertrophy and failure
Pulmonary congestion
Low CO
Clinical manifestations of Mitral Stenosis
DOE, Fatigue, Palpitations
Hemoptysis
Hoarseness
Dysphagia
JVD
Orthopnea
PND, Cough
Afib
S1
Opening Snap
What would you hear upon auscultation of Mitral Stenosis?
Diastolic Murmur
What are the hemodynamic effects of Mitral Regurge?
valve failing to close causes increased volume load on left Atrium and Ventricle
What are the Clinical Manifestations of Mitral Regurge?
DOE, Fatigue, Palpitations
Crackles
PND
Afib
S3 and/or S4
Which type of murmur would be heard with Mitral Regurge?
Systolic Murmur
Which Valve disorder has a mid-systolic click?
MVP
***usually asymptomatic
Which valve disorder?
Decreased forward flow and incomplete left ventricular emptying
Pulmonary Congestion
Left Ventricular Hypertrophy
Aortic Stenosis
***very serious
Clinical manifestations of Aortic Stenosis
DOE, Fatigue, Palpitations
LV HF
Syncope
Narrow Pulse Pressure
Angina
S3 and/or S4
Which heart murmur with Aortic Stenosis?
Systolic Murmur
Which valve problem?
Failure to close leads to increased vol load on left heart and causes Left Ventricular Dilation and Hypertrophy.
Aortic Regurge
Clinical Manifestations of Aortic Regurge
DOE, Fatigue, Palpitations
Widened Pulse Pressure
Angina
S3
Which murmur with Aortic Regurge?
Diastolic Murmur
Which valve replacement is lifelong and requires anticoagulants?
Mechanical Valve Replacement
***very durable
Which valve replacement is less durable but doesn’t need anticoagulants?
Tissue Valve Replacement
***older clients who could fall and you don’t want them on anticoagulants
What is the most common form of Cardiomyopathy?
Dilated Cardiomyopathy
- ventricles are enlarged and can’t push out enough
***SV decrease
What is the least common form of Cardiomyopathy?
Restrictive Cardiomyopathy
- ventricles are stiff and rigid
***filling of ventricles isn’t sufficient
What are the mechanical consequences of Hypertrophic Cardiomyopathy?
Aortic Valve outflow is obstructed
Which form of cardiomyopathy is a problem with diastolic function?
Restrictive Cardiomyopathy
***ventricles too stiff to fill properly during diastole
ETOH abuse is a risk factor for which type of HF?
Cardiomyopathy
