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Theory > Week 5 - Cardiac Dysfunction, Rhythm Changes, Heart Failure, and Circulatory Problems > Flashcards

Week 5 - Cardiac Dysfunction, Rhythm Changes, Heart Failure, and Circulatory Problems Flashcards

1
Q

What is sinus bradycardia?

A

Heart rate < 60 bpm; linked to vagal tone and medications.

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2
Q

Goal of therapy for acute heart failure?

A

Improve ventricular function by reducing volume and enhancing oxygenation.

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3
Q

Devices for heart failure management?

A

Includes CRT-D, ICD, and ventricular assist devices.

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4
Q

Managing physical activity in heart failure?

A

Activity as tolerated; avoid strain and monitor for complications.

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5
Q

Significance of reducing anxiety in heart failure?

A

Improves comfort and may enhance heart function.

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6
Q

Role of vasodilators in heart failure?

A

Reduce afterload, improving cardiac output.

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7
Q

Goals for myocardial contractility?

A

Enhance contractility; decrease preload and afterload.

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8
Q

Drugs enhancing myocardial contractility?

A

Nitrates, Loop Diuretics, ACE inhibitors, Beta Blockers.

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9
Q

Modalities for complicated cardiomyopathy?

A

Ventricular assist device, surgery, heart transplant.

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10
Q

Forms of nitrates?

A

Sublingual, oral, IV, transdermal, sprays.

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11
Q

Common adverse effects of nitrates?

A

Headaches, dizziness, reflex tachycardia.

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12
Q

Preventing nitrate tolerance?

A

Regular nitrate-free periods.

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13
Q

Mechanism of nitroglycerin?

A

Causes vasodilation, improving coronary blood flow.

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14
Q

Purpose of rapid-acting nitroglycerin?

A

Treat acute anginal attacks.

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15
Q

Role of anticoagulants?

A

Prevent clot formation by inhibiting clotting factors.

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16
Q

Anticoagulants vs. antiplatelets?

A

Anticoagulants inhibit clotting; antiplatelets inhibit aggregation.

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17
Q

Significance of the clotting cascade?

A

Amplifies reactions leading to clot formation.

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18
Q

Pathways in the clotting cascade?

A

Intrinsic and extrinsic pathways.

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19
Q

Function of antiplatelet drugs?

A

Prevent platelet plugs; no effect on existing clots.

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20
Q

Effect of nitrates on ischemic tissue?

A

Increases oxygen delivery.

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21
Q

Instructions for transdermal nitrate patches?

A

Remove at bedtime; apply new patch in the morning.

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22
Q

Consequences of an embolus in a coronary artery?

A

Causes myocardial infarction.

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23
Q

Embolus obstructing a brain vessel?

A

Causes a stroke (CVA).

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24
Q

Embolus effect on lungs?

A

Causes pulmonary embolus (PE).

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25
Q

Embolus in a leg vein?

A

Leads to deep vein thrombosis (DVT).

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26
Q

Define thromboembolic events.

A

Include MI, stroke, PE, and DVT.

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27
Q

Mechanism of action of warfarin?

A

Inhibits Vitamin K dependent clotting factors.

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28
Q

Antagonist for warfarin?

A

Phytonadione (Vitamin K).

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29
Q

Administration of unfractionated heparin?

A

Administered as an anticoagulant.

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30
Q

Lab values for warfarin monitoring?

A

Monitor INR and PT.

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31
Q

Therapeutic INR range?

A

2-3.5 seconds.

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32
Q

Risks of warfarin therapy?

A

High bleeding risk; monitor for signs.

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33
Q

Dosing frequency for warfarin?

A

Dosed daily.

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34
Q

Time to peak effect of warfarin?

A

About 4 hours.

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35
Q

Elimination half-life of warfarin?

A

3-5 days.

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36
Q

Common drug interactions with warfarin?

A

Includes various antibiotics.

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37
Q

Normal PT range without warfarin?

A

0.8-1.2 seconds.

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38
Q

Primary use of warfarin?

A

Prevent thromboembolic events.

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39
Q

INR’s role in coagulability?

A

Standardizes PT results across methods.

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40
Q

Nursing management for anticoagulants?

A

Monitor bleeding, educate on fall risks.

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41
Q

What is DVT prophylaxis?

A

Preventive measures to reduce DVT risk.

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42
Q

Mechanism of action of tinzaparin?

A

Inhibits factor Xa and thrombin.

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43
Q

Indications for tinzaparin?

A

Prevention and treatment of DVT and PE.

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44
Q

Contraindications for tinzaparin?

A

Active bleeding and severe thrombocytopenia.

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45
Q

Common adverse effects of anticoagulants?

A

Internal and superficial bleeding.

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46
Q

Nursing management for tinzaparin?

A

Monitor for bleeding and check platelet counts.

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47
Q

Dosage determination for tinzaparin?

A

Based on weight and indication.

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48
Q

Anticipation for bleeding in IV heparin patients?

A

Hold heparin, check PTT, and prepare for endoscopy.

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49
Q

Significance of monitoring PTT levels?

A

Ensures therapeutic anticoagulant effect.

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50
Q

Most common adverse effect of anticoagulants?

A

Internal and superficial bleeding.

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51
Q

Instructions for subcutaneous tinzaparin?

A

Use a new, sterile needle.

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52
Q

Define Peripheral Artery Disease (PAD).

A

Thickening of artery walls, narrowing of extremities.

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53
Q

PAD symptoms in lower extremities?

A

Intermittent claudication, paresthesia, and coldness.

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54
Q

Leading cause of PAD?

A

Atherosclerosis related to inflammation.

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55
Q

Risk factors for PAD?

A

Tobacco use, diabetes, and hypertension.

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56
Q

Significance of intermittent claudication?

A

Indicates inadequate blood flow during activity.

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57
Q

Clinical features of PAD?

A

Intermittent claudication, coldness, and diminished pulse.

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58
Q

Atherosclerosis and PAD?

A

Leads to arterial wall thickening and narrowing.

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59
Q

Consequences of critical limb ischemia?

A

Rest pain, ulcers, and gangrene.

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60
Q

Condition of arterial wall thickening?

A

Peripheral Artery Disease (PAD).

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61
Q

Therapeutic approaches for PAD?

A

Antiplatelets, exercise, and surgery.

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62
Q

Diagnostic studies for PAD?

A

Doppler ultrasonography and angiography.

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63
Q

Complications of PAD?

A

Delayed healing and risk of amputation.

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64
Q

Risk factor modification in PAD?

A

Key to reducing disease progression.

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65
Q

Mechanism of acetylsalicylic acid (ASA)?

A

Acts as an antiplatelet and NSAID.

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66
Q

Indications for clopidogrel (Plavix)?

A

Prevention of blood clots.

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67
Q

Nursing management for ASA?

A

Monitor for adverse effects and interactions.

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68
Q

Adverse effects of clopidogrel?

A

Bleeding and gastrointestinal upset.

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69
Q

Importance of smoking cessation in PAD?

A

Improves blood flow and reduces symptoms.

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70
Q

Lifestyle modifications for right-sided heart failure?

A

Reduce sodium, maintain weight, and manage stress.

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71
Q

Role of captopril in heart failure?

A

ACE inhibitor that lowers blood pressure.

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72
Q

Monitoring adverse effects of hydrochlorothiazide?

A

Check for electrolyte imbalances and dehydration.

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73
Q

Reason for switching to diltiazem?

A

Calcium channel blocker for better blood pressure control.

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74
Q

Diltiazem’s effect on hypertension?

A

Inhibits calcium entry, lowering blood pressure.

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75
Q

Explain need for medication with BP 140/72?

A

Consistent management prevents complications.

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76
Q

Adverse effects of diltiazem?

A

Dizziness, headache, and bradycardia.

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77
Q

ECG findings in sinus tachycardia?

A

Heart rate > 100 bpm, normal P waves.

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78
Q

Define heart failure (HF).

A

Inability to pump sufficient blood; contractility issues.

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79
Q

Clinical manifestations of heart failure?

A

Shortness of breath, fatigue, and edema.

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80
Q

Diagnostics for heart failure?

A

Echocardiography and chest X-ray.

81
Q

Management strategies for heart failure?

A

Lifestyle changes and medications.

82
Q

Complications of PAD?

A

Critical limb ischemia and gangrene.

83
Q

Clinical manifestations of PAD?

A

Intermittent claudication and leg weakness.

84
Q

Collaborative care for PAD?

A

Lifestyle changes and possible surgery.

85
Q

Modifiable risk factors for hypertension?

A

Obesity, inactivity, and high salt intake.

86
Q

Non-modifiable risk factors for hypertension?

A

Age, family history, and gender.

87
Q

Target organs damaged by hypertension?

A

Heart, kidneys, eyes, and brain.

88
Q

Complications of hypertension?

A

Heart attack and stroke.

89
Q

Pharmacological classifications for hypertension?

A

Diuretics, ACE inhibitors, and beta-blockers.

90
Q

Define dysrhythmias.

A

Abnormal cardiac rhythms needing assessment.

91
Q

Importance of assessing dysrhythmias?

A

Critical for effective treatment.

92
Q

Properties of cardiac cells?

A

Automaticity, excitability, conductivity, contractility.

93
Q

Role of vagus nerve in heart rate?

A

Decreases heart rate and contractility.

94
Q

Sympathetic nervous system effect on heart?

A

Increases heart rate and contractility.

95
Q

Pathway of normal cardiac impulse?

A

SA node → AV node → bundle of His → Purkinje fibers.

96
Q

Function of the SA node?

A

Natural pacemaker of the heart.

97
Q

ECG waveforms and cardiac activity?

A

Reflect electrical impulses of the heart.

98
Q

Effect of vagus nerve activation?

A

Slows heart rate by decreasing SA node firing.

99
Q

Sequence of impulse transmission?

A

SA node → atrial myocardium → AV node → bundle of His.

100
Q

Normal range for sinus rhythms?

A

60 to 100 beats per minute.

101
Q

Define sinus bradycardia (SB).

A

Heart rate < 60 bpm with regular rhythm.

102
Q

ECG presentation of sinus tachycardia (ST)?

A

Heart rate > 100 bpm, regular rhythm.

103
Q

Causes of sinus bradycardia?

A

Decreased SA node firing and increased vagal tone.

104
Q

Clinical significance of sinus bradycardia?

A

Decreased cardiac output and potential syncope.

105
Q

Treatment for symptomatic sinus bradycardia?

A

Atropine and possible pacemaker.

106
Q

Rules for sinus bradycardia?

A

Rate < 60 bpm, regular rhythm, normal P waves.

107
Q

Causes of sinus tachycardia?

A

Increased SA node firing from various factors.

108
Q

Clinical significance of sinus tachycardia?

A

Dizziness and potential myocardial ischemia.

109
Q

Treatment for symptomatic sinus tachycardia?

A

Treat underlying cause and consider drug therapy.

110
Q

ECG characteristics of normal sinus rhythm?

A

Heart rate 60-100 bpm, regular rhythm.

111
Q

Normal sinus bradycardia in athletes?

A

Can occur in trained athletes and with certain maneuvers.

112
Q

Complications from sinus tachycardia?

A

Angina due to increased myocardial oxygen demand.

113
Q

Heart rate range for sinus tachycardia?

A

Greater than 100 beats per minute.

114
Q

Common conditions leading to arrhythmias?

A

Heart failure and myocardial infarction.

115
Q

Non-cardiac conditions causing arrhythmias?

A

Electrolyte imbalances and drug effects.

116
Q

Dysrhythmias and treatment options?

A

Cause influences specific management strategies.

117
Q

Priority assessments for bradycardia or tachycardia?

A

Vital signs and heart evaluation.

118
Q

Define arrhythmias and causes.

A

Irregular heartbeats from various conditions.

119
Q

Role of diagnostic tests in dysrhythmias?

A

Evaluate dysrhythmias and treatment effectiveness.

120
Q

Lifestyle factors contributing to arrhythmias?

A

Alcohol and caffeine use.

121
Q

Significance of electrolyte imbalances?

A

Can disrupt heart’s electrical activity.

122
Q

Impact of hypoxia on cardiac rhythm?

A

Can lead to arrhythmias due to impaired function.

123
Q

Myocardial infarction and arrhythmias?

A

Can cause arrhythmias from heart muscle damage.

124
Q

Heart failure and its impact?

A

Impaired pumping and filling, reduced quality of life.

125
Q

Calculating cardiac output in heart failure?

A

CO = HR x SV.

126
Q

Primary risk factors for heart failure?

A

Coronary artery disease and hypertension.

127
Q

Define heart failure with reduced ejection fraction (HF-REF).

A

Inability to pump blood effectively.

128
Q

HF-PEF vs. HF-REF?

A

HF-PEF is filling issue; HF-REF is pumping issue.

129
Q

Heart failure prevalence in Canada?

A

1 in 5 over 40 will experience heart failure.

130
Q

Diabetes mellitus and heart failure?

A

Type 2 diabetes linked to heart failure risk.

131
Q

Heart failure of mixed origin?

A

Compounded systolic and diastolic dysfunction.

132
Q

Common symptoms of heart failure?

A

Impaired exercise tolerance and pulmonary congestion.

133
Q

Obesity’s role in heart failure risk?

A

Increases strain on the heart.

134
Q

Main types of heart failure?

A

HFrEF and HFpEF.

135
Q

Define myocardial hypertrophy.

A

Enlargement of heart muscle, affecting function.

136
Q

Decreased cardiac output and recovery?

A

Slowed recovery and symptoms like dyspnea.

137
Q

Significance of valvular rigidity?

A

Causes turbulence and contributes to heart failure.

138
Q

Arterial wall stiffness and blood pressure?

A

Prevents stretching, increasing blood pressure.

139
Q

SDOH increasing diabetes risk in Indigenous populations?

A

Intergenerational trauma and food insecurity.

140
Q

Diagnosing HFpEF?

A

Symptoms with EF ≥ 50%.

141
Q

Normal ejection fraction range?

A

55% to 70%.

142
Q

Characteristics of mixed heart failure?

A

Poor systolic function with filling issues.

143
Q

Common causes of heart failure?

A

Hypertension and myocardial ischemia.

144
Q

Heart failure and cardiovascular disease in older adults?

A

Leading cause of death in those 85+.

145
Q

Systolic vs. diastolic heart failure?

A

Systolic: impaired pumping; diastolic: impaired filling.

146
Q

HR, SV, and CO relationship?

A

CO = HR x SV.

147
Q

Poor ejection fractions in heart failure?

A

Indicate severe heart failure and high pulmonary pressures.

148
Q

Formula for calculating CO?

A

CO = HR x SV.

149
Q

Compensatory mechanisms in heart failure?

A

Maintain CO through various adaptations.

150
Q

SNS activation in heart failure?

A

Increases HR and contractility but worsens heart failure.

151
Q

Neurohormonal response in heart failure?

A

RAAS activation increases blood pressure and contractility.

152
Q

Ventricular dilation significance?

A

Adaptation to high pressures but decreases output over time.

153
Q

Consequences of ventricular hypertrophy?

A

Poor contractility and risk for arrhythmias.

154
Q

Counterregulatory mechanisms in heart failure?

A

Natriuretic peptides counteract heart failure effects.

155
Q

Right-sided vs. left-sided heart failure?

A

Right: peripheral edema; left: pulmonary congestion.

156
Q

Primary cause of right-sided heart failure?

A

Left-sided heart failure.

157
Q

Left-sided heart failure and lungs?

A

Causes pulmonary congestion and edema.

158
Q

Symptoms of acute decompensated heart failure?

A

Increased dyspnea and fatigue.

159
Q

Skipping diuretic effects?

A

Fluid retention and worsening symptoms.

160
Q

Define pulmonary edema?

A

Fluid in lungs, impairing gas exchange.

161
Q

Vital signs indicating acute heart failure?

A

Elevated heart rate and blood pressure.

162
Q

Fluid movement in pulmonary edema?

A

Increased pressure pushes fluid into alveoli.

163
Q

Physical findings in pulmonary edema?

A

Tachypnea and respiratory distress.

164
Q

Decreased CO and nocturia relationship?

A

Fluid shifts at night increase urination.

165
Q

Behavioral changes in heart failure?

A

Depression and confusion.

166
Q

Chronic edema skin changes?

A

Dusky coloration and shiny skin.

167
Q

Early and later signs of pulmonary edema?

A

Increased respiratory rate and tachypnea.

168
Q

Clinical manifestations of right-sided heart failure?

A

Peripheral edema and weight gain.

169
Q

Left-sided heart failure clinical presentation?

A

Pulmonary edema and dyspnea.

170
Q

Sudden weight gain significance in heart failure?

A

Indicates exacerbation of heart failure.

171
Q

Behavioral changes in heart failure?

A

Restlessness and confusion.

172
Q

Skin changes indicating heart failure?

A

Dusky and cool skin with pigmentation changes.

173
Q

Respiratory symptoms in heart failure?

A

Dyspnea and pulmonary edema.

174
Q

Signs of fluid retention in heart failure?

A

Peripheral edema and ascites.

175
Q

Heart failure effects on heart rate?

A

Increased heart rate and pulsus alternans.

176
Q

Gastrointestinal symptoms in heart failure?

A

Anorexia and nausea.

177
Q

Crackles and heart sounds in heart failure?

A

Indicate pulmonary congestion and fluid overload.

178
Q

Heart failure impact on nocturnal symptoms?

A

Leads to nocturia and breathing difficulties at night.

179
Q

Heart failure and renal function relationship?

A

Can lead to renal failure and fluid retention.

180
Q

Importance of monitoring chest pain in heart failure?

A

Indicates underlying cardiac issues.

181
Q

Potential weight changes in heart failure?

A

Weight gain due to fluid retention.

182
Q

Complications of heart failure?

A

Pleural effusion and arrhythmias.

183
Q

Disorganized rhythms and stroke risk?

A

Increase thrombus formation risk.

184
Q

Treatments for arrhythmias in heart failure?

A

Rate control and antiarrhythmic medications.

185
Q

Primary goal in diagnosing heart failure?

A

Determine underlying etiology.

186
Q

Diagnostic orders for suspected heart failure?

A

Chest X-ray and ECG.

187
Q

Echocardiography in heart failure diagnosis?

A

Assesses function and measures ejection fraction.

188
Q

Significance of measuring ejection fraction?

A

Differentiates HFrEF from HFpEF.

189
Q

Laboratory data in heart failure assessment?

A

Cardiac enzymes and BNP levels.

190
Q

History and physical exam in heart failure diagnosis?

A

Identify causes and severity.

191
Q

Cardiac catheterization in heart failure diagnosis?

A

Provides hemodynamic assessment.

192
Q

Loop diuretics in acute heart failure?

A

Decrease volume and improve function.

193
Q

Morphine in heart failure management?

A

Reduces preload and improves oxygenation.

194
Q

Define preload in heart failure?

A

Volume of blood returning to the heart.

195
Q

Dietary recommendations for chronic heart failure?

A

Low sodium and limit saturated fats.

196
Q

Importance of daily weight monitoring?

A

Detects worsening heart failure symptoms.

197
Q

Oxygen therapy in heart failure?

A

Indicated when SpO2 < 90%.

198
Q

Pharmacological treatments for chronic heart failure?

A

Includes diuretics and ACE inhibitors.

199
Q

Purpose of inotropic drugs in heart failure?

A

Enhance contractility and improve output.

Theory (23 decks)

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