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CNUR 203 midterm > unit 3 HF > Flashcards

unit 3 HF Flashcards

1
Q

SBP

A

Systolic pressure is the peak arterial pressure that occurs during ventricle contraction

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2
Q

DBP

A

diastolic pressure is the minimal aortic pressure just before the ventricle ejects blood during relaxation, also called filling pressure

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3
Q

Cardiac output

A

HR x SV

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4
Q

SVR

A

Force opposing blood moving within a vessel

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5
Q

Sustained Hypertension

A

140/90

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6
Q

Hypertension for people with diabetes

A

130/80

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7
Q

what is happening during systole and diastole in a patient with hypertension?

A

Putting a lot of force on the contraction, pushing really hard. The muscle gets tired and stressed out. If you cannot relax enough you will not fill up, you will end up with edema SOB ect.

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8
Q

Stage 1 Hypertension

A

140-159/90-99

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9
Q

Stage 2

A

SBP 160
DBP 100

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10
Q

White coat hypertension

A

nervous when getting BP taken goes up

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11
Q

why are people with hypertension out of break

A

O2 demands increase

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12
Q

What is happening to the vessels with hypertension

A

constrict too much or cannot relax

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13
Q

modifiable risks for hypertension

A

genetic, age, male, female and age, type 1 diabetes

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14
Q

Modifiable risk factors for hypertension

A

lack of education, diet to much to little of what, lack of exercise, stress, smoking, alcohol, obesity, hyperglycaemia, head injury

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15
Q

what labs should be ordered with hypertension

A

potassium, glucose ect.

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16
Q

why do a 24 hour ambulatory BP screening

A

to see how hypertension fluctuates throughout the day

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17
Q

why check the serum glucose

A

patients with high blood pressure are more resistant to insulin-stimulated glucose uptake than matched control groups with normal blood pressure.

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18
Q

Diuretics

A

meds that help you move extra fluid and salt out of your body (make you pee more frequently) decrease circulating blood volume

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19
Q

ACEI

A

(Angiotensin-converting enzyme inhibitor) “pril” Prevent vessel from getting tight

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20
Q

ACEI

A

(Angiotensin converting enzyme inhibitor) “pril” Prevent vessel from getting tight

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21
Q

ARB

A

(angiotensin II receptor blocker) “sartan” Prevent vessel from getting tight

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22
Q

CCB

A

(calcium channel blocker) “pine” Stimulates the heart

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23
Q

Things to teach hypertensive patients

A

-diet, exercise, weight loss, lifestyle modifications, med, 3F’s (fat, fluid, fibre)
-Good mix of cardiac and muscular exercise)

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24
Q

What is the dash diet

A

Sodium-restricted diet for people with high BP.
3300, 2300, or 1500 mg of salt daily

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25
Q

What foods are in the dash diet

A

veggies, fruit, grain, milk, meat, nuts, seeds, dry beans, oil

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26
Q

Potential complications for hypertension

A

-CAD vessels tighten and form plaque
-left ventricular hypertrophy the heart muscle get bigger
-TIA
-MI
-Embolic stroke
-PAD
-end stage organ failure, renal, eyes

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27
Q

Hypertensive crisis

A

anything 180/120 over

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28
Q

Incompetent valves

A

-Too open (regurgitation)
-Too closed (stenosis)

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29
Q

Stenosis

A

-Valve orifice is restricted
-forward blood flow is impeded
-A pressure gradient is created across open valve
-Pressure gradient differences reflect the degree of stenosis

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30
Q

Regurgitation

A

Incomplete closure of valve leaflets results in backward flow of blood

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31
Q

Regurgitation can be caused by

A

MI, Chronic rheumatic heart disease,

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32
Q

What is paroxysmal nocturnal dyspnea

A

Paroxysmal nocturnal dyspnea (PND) is a sensation of shortness of breath that awakens the patient

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33
Q

how does regurgitation effect structure

A

changes the structure of the leaflets, chord tendinae, papillary muscle, left atrium, or left ventricle causes incomplete closure of the valves

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34
Q

Prolapse

A

change in structure of the leaflets, charade, tendinae, papillary muscle, left atrium, left ventricle causes the leaflets to concave during systole

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35
Q

Valve failure assessment

A

energy level, angina, SOBOE, Edema, heart murmur because of the ability to pump blood

36
Q

Tests for valve failure

A

CXR, ECG, Trans thoracic ECHO, Trans Esophageal Echo, CARDIAC CATHETERIZATION

37
Q

Medication for Valve failure

A

Digitalis, Vasodilators, diuretics, blockers, anticoagulants, antidysrhythmic

38
Q

Things to teach with valve replacement

A

Symptom management, preventative antibiotics, lifestyle, medication complications

39
Q

Endocarditis

A

Bacteria delivers the organism to the surface of the valve, adhere on the valves eventual invasion of the valvular leaflets

40
Q

Cardiac output

A

Cardiac output (CO) is the amount of blood pumped by the heart minute and is the mechanism whereby blood flows around the body.

41
Q

Ejection fraction

A

Ejection fraction is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction.

42
Q

Ventricular remodelling

A

refers to changes in the heart’s size and shape that occur in response to cardiac disease or cardiac damage. When doctors talk about “remodelling,” they are usually talking about the left ventricle, though occasionally this term is applied to other cardiac chambers.

43
Q

Cardiomegaly

A

An enlarged heart (cardiomegaly) is an increase in the size of the heart.

44
Q

Ventricular dilation

A

Dilated cardiomyopathy (DCM) is a condition in which the left ventricle, the heart’s main pumping chamber, is enlarged (dilated).

45
Q

Ventricular hypertrophy

A

If the heart has to work too hard to pump blood, the muscles in the walls of the left ventricle thicken. This thickening is called hypertrophy. Hypertrophy means growing (trophy) too much (hyper). Left ventricular hypertrophy (LVH) makes it harder for the heart to pump blood efficiently.

46
Q

Pleural effusion

A

Pleural effusion is the buildup of too much fluid between the layers of your pleura around your lungs.

47
Q

Thrombus

A

A thrombus is a healthy response to injury intended to stop and prevent further bleeding,

48
Q

Hepatomegaly

A

An enlarged liver is a sign of an underlying problem, such as liver disease, congestive heart failure or cancer.

49
Q

A regular LVEF is

A

55%

50
Q

Why does EF drop with heart failure

A

the heart’s lower left chamber (left ventricle) doesn’t pump blood out to the body as well as it should. It’s sometimes called systolic heart failure.

51
Q

How to calculate the ejection fraction

A

Amount of blood pumped out of the ventricle divided by total amount of blood in the ventricle

52
Q

coronary artery disease

A

blockages in your coronary arteries that limit blood flow to your heart muscle which weakens or damages the heart muscles and impairs the muscles ability to pump

53
Q

Cardiomyopathy

A

a disease of the heart muscle. The muscle is weakened which affects its ability to pump properly

54
Q

How does high blood pressure effect heart failure

A

The heart has to work extra hard to pump against increased pressure which weakens the muscle

55
Q

Aortic stenosis

A

Opening of aortic valve is narrowed imparting blood flow, the heart works harder to pump blood through the narrowed valve, weakening the muscles

56
Q

Mitral Regurgitation

A

Increases blood volume stretched and weakens heart muscles

57
Q

Arrhythmia

A

Irregular heart beat, irregular rhythm reduces the pumping effectiveness of the heart

58
Q

Primary Heart failure

A

Causes are the primary condition or disease process leading to the development of HF.

59
Q

Preciptants of heart failure

A

Precipitants are triggers or contributing factors for decompensation in patients with established chronic heart disease.

60
Q

Systolic heart failure

A

reduced EF

61
Q

Risk factors for HF

A

CAD, Hypertension, diabetes, MI, any type of heart disease

62
Q

Left Heart failure

A

most common
-blood backs up into pulmonary veins
-Fluid backs up in alveoli LUNGS
-Pulmonary congestion, edema, review under complications
-Usually start with left and then develop right
-Goes to lungs

63
Q

Left heart failure symptoms

A

Pulmonary conjestion, Dyspnea, cough, crackles, O2 Sat, Fatigue, Mentation changes, Paroxysmal nocturnal, Duspnea

64
Q

Right ventricle Heart failure

A

Systemic congestion, edema, lower extremity edema, ascites, weight gain, liver enlargement, JVD, Anorexia/nausea

65
Q

Symptoms of Right sided heart failure

A

chest discomfort, breathlessness, palpitations, and body swelling.

66
Q

How does the heart compensate when in heart failure

A

Atria enlarges, The heart walls thicken (the muscles). It remodels.

67
Q

Dilation of the heart

A

Muscle fibres stretch in response to the extra volume of blood still in the heart at the end of diastole, adaptive, short term fix

68
Q

Hypertrophy

A

Increase in muscle mass and cardiac wall thickening in response to chronic dilation, resulting in poor contractility, higher O2 needs, poor coronary artery circulation, risk for ventricular dysrhythmias

69
Q

Sympathetic Nervous system compensation

A

Increase HR, Increase contractility, Increase cardiac output, Vasoconstriction, Increase workload and volume on the heart

70
Q

class 1 HF

A

No limitations of physical activity, ordinary physical activity foes not cause fatigue, dyspnea, palpations, or angina

71
Q

Class 2

A

Slight limitation of physcical activity no symptoms at rest. Ordinary physical activity results in fatigue, dyspnea, palpations or angina

72
Q

Class 3

A

Marked limitation of physical activity. Usually comfortable at rest. Ordinary physical activity causes fatigue, dyspnea, palpations, or agina

73
Q

Class 4

A

Inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of angina may be present even at rest. If an physical activity is undertaken, discomfort is increased

74
Q

Pulmonary edema

A

Pulmonary edema is a condition caused by too much fluid in the lungs. This fluid collects in the many air sacs in the lungs, making it difficult to breathe. In most cases, heart problems cause pulmonary edema. But fluid can collect in the lungs for other reasons.

75
Q

Complications in Pulmonary Edema

A

Sudden increased RR, anxious pale/cyanotic, tell them not to panic

76
Q

Assessment for pulmonary edema

A

cough with frothy, blood tinged sputum, Breath sounds: crackles wheeze, rhonchi, tachycardia, hypotension or hypertension, orthopnea, dyspnea, tachypnea, cyanosis, cool and clammy skin

77
Q

Nursing intervention for Pulmonary Edema

A

DO not wait for an order, safe the patient, put on oxygen, drop left, put arms up (tripod position)

78
Q

AAT

A

uses a sample of blood or a cheek swab to diagnose a condition called alpha-1 antitrypsin deficiency (AAT deficiency). Made by the liver

79
Q

Furosemide

A

diuretics

80
Q

Enapril

A

used alone or in combination with other medications to treat high blood pressure.

81
Q

What does a chest x ray tell you

A

look at the structures and organs in your chest .It can help your healthcare provider see how well your lungs and heart are working.

82
Q

What does an ECHO tell you

A

The test can help a health care provider diagnose heart conditions. An echocardiogram uses sound waves to create pictures of the heart. This common test can show blood flow through the heart and heart valves. Your health care provider can use the pictures from the test to find heart disease and other heart conditions.

83
Q

Lab tests to complete with Heart failure

A

BNP, Lytes, ABG, CXR, ECG, ECHO

84
Q

Abnormal test results with HF

A

High NA, Low K, Low urea, High BNP

85
Q

What does a HF patent need

A

O2, Rest, Cath, positioning (fowlers), IV access, meds

CNUR 203 midterm (10 decks)

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