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2514 Patho/phys/assess > Week 5 Heart failure and dysrhythmias > Flashcards

Week 5 Heart failure and dysrhythmias Flashcards

1
Q

What are the classic signs of Heart failure?

A
  1. Edema
  2. Pulmonary edema (auscultate lungs for crackles)
  3. SOB
  4. Crackles
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2
Q

What the 2 risk factors for HF?

A
  1. CAD
  2. HTN
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3
Q

What is cardiomyopathy and what are the 2 reasons it occurs?

A

damage to the heart muscle so it can’t pump efficiently
1. Stenosis - tight valve - increased workload
2. Loose valve- back flow

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4
Q

What 2 chronic conditions cause contractility heart issues?

A
  1. CAD
  2. Cardiomyopathy - stenosis/loose valve
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5
Q

What 2 acute conditions cause contractility heart issues?

A
  1. acute MI (STEMI)
  2. Myocarditis - inflammation
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6
Q

What 2 things impact afterload?

A

HTN
Pulmonary disease (ex COPD)

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7
Q

What affects preload that leads to HF?

A
  1. hypotension
  2. valve disease
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8
Q

what 4 events cause a lack of O2 to the heart coronary system?

A
  1. CAD
  2. Heart block
  3. heart Failure
  4. arrythmia
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9
Q

what is HF with reduced EF?

A

<40%
pump issue - systolic dysfunction

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10
Q

What is HF with preserved EF?

A

<40%
filling issue - dystolic dysfunction

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11
Q

What are the 4 HF compensatory mechanisms

A
  1. SNS
  2. RAAS
  3. Ventricular Dilation - LV enlarges - stretch too far = ventricular remodeling
  4. Ventricular hypertrophy- enlarged heart =dysrhythmias
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12
Q

what type of meds do we use to help reduce compensatory mechanisms?

A
  1. SNS- beta blockers
  2. RAAS - ACE/ARB/ARNI
  3. ventricular dilation-
  4. ventricular hypertrophy -
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13
Q

what are the signs of LSHF perfusion issue?

A

fatigue
confused
tachy (SNS compensation)
angina (less O2 to heart)
Oliguria <400ml in 24 hrs
pallor
cool
weak pulse

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14
Q

what are the signs of LSHF congestion issue?

A

cough
dyspnea (alveoli take on water)
orthopnea - can’t breathe laying down
paroxythal nocturnal dyspnea -waking at night SOB
adventisia in lungs
pink sputum - frothy
S3 & S4 sounds

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15
Q

how does LSHF happen?

A

blood backs up to the pulmonary system
issue with Left ventricle

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16
Q

how does RSHF happen?

A

blood backs up to the venous system
issue with right ventricle

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17
Q

What are the signs of RSHF?

A

weight gain - edema
increase BP - affects afterload
JVD
N&V- acities
distended abdomen
liver & speen enlarged
Polyuria at night b/c gravity at kidneys
dependent edema

18
Q

Does hyperkalemia and hypokalemia slow heart impulses or increase heart impulses?

A

both SLOW impulses

19
Q

What are the most common indicators of hypokalemia?

A
  1. *U wave
  2. low T wave
  3. PQ elongated
  4. QT increased
20
Q

What are the most common indicators of hyperkalemia ?

A
  1. *T wave peak
  2. P- very low
  3. PQ elongated
  4. QRS wider
21
Q

What is the most common dysrythmia?

A

afib

22
Q

What are the after load drugs (blue)?

A

ARNI- sacubiteil/valsartanw(entresto)
ACE- captopril
ARBS- losartin (cozar)
Beta blocker- metoprolol
Calcium Chanel blocker - verapramil
Vasodilation - hydralazine

23
Q

What are the preload drugs (green) ?

A
  1. Morphine
  2. SLGT-2 - canagliflozin
  3. Diuretics- all 3
  4. Beta blocker - metoprolol
  5. Nitrates - nitro spray - relaxes vasoapasm in coronary arteries only & veins ( isosorbide dineitrate)
24
Q

what is the 3 goals of meds for heart failure?

A
  1. reduce cardiac workload (afterload)
  2. control pain (preload)
  3. prevent/destroy clots
25
Q

what do contractility meds help with?

A

forward flow

26
Q

what is an example of a contractility med?

A

digoxin

27
Q

what are the 3 drugs for Afib that slow ventricular rate?

A

beta-adrinergic blockers
calcium channel blockers
digoxen

28
Q

What drug helps prevent blood clots in Afib?

A

warfarin

29
Q

why are vasodilators taken short term?

A

tolerance develops

30
Q

what is the adverse affect of vasodilators (Hydralazine) and how do we prevent it?

A

reflex tachy
with beta blocker

31
Q

what does aldosterone cause?

A

sodium & water uptake

32
Q

what does angiotension II cause?

A

vasoconstriction

33
Q

what is ventricular remodeling?

A

when there is to much blood so the ventricles stretch and the cells start to change. The ventricle changes because the cells are changing

34
Q

why is ventricular remodeling bad?

A

because it causes the cells to change and demand more O2.
so ischemia
and arrythmias

35
Q

what do cardiac cells release to help compensate?

A

naturetic peptide

36
Q

blocking RAAS causes sodium and water to do what?

A

leave the body

37
Q

What does P wave represent?

A

Atrial depolarization (SA to AV)

38
Q

what must we know BEFORE giving Dig and why?

A

K+ level!
hypokalemia will cause hypereffect with dig
hyperkalemia will compete with Dig and reduce affect

39
Q

what 2 conditions is dig used in?

A

HF and Afib

40
Q

what 3 patients cannot have tPA?

A
  1. intracranial hemorrhage
  2. recent stroke (<3 months)
  3. active internal bleeding

2514 Patho/phys/assess (27 decks)

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