Week 6

Question 1

Heart failure is associated with?

Answer 1

longstanding hypertension, CAD, MI, DM, cigarette smoking and high cholesterol.

Question 2

Heart failure is characterized by?

Answer 2

ventricular dysfunction, reduced exercise tolerance, diminished quality of life and shortened life expectancy

Question 3

Heart failure involves?

Answer 3

impaired cardiac pumping or filling

Question 4

Pathophysiology of HF?

Answer 4

any alterations in the normal mechanisms regulating cardiac output (Preload, afterload, myocardial contractility, heart rate and metabolic state) of the individual can lead to ventricular dysfunction and result in HF

Question 5

Most common type of HF?

Answer 5

Systolic HF

Question 6

Hallmark of systolic HF?

Answer 6

a decrease in LV ejection fraction

Question 7

Systolic HF

Answer 7

the left ventricle loses its ability to generate enough pressure to blood forward through the high pressure aorta

Question 8

Diastolic HF is?

Answer 8

Impaired ability of the ventricles to fill during diastole. Decreased filling of the ventricles will result in decreased stroke volume, thus creating high filling pressures in the pulmonary system

Question 9

Diagnosis of diastolic heart failure is made on the presence of?

Answer 9

pulmonary congestion

Question 10

Diastolic HF is usually the result of?

Answer 10

Left ventricular hypertrophy

Question 11

Mixed systolic and diastolic HF is seen in?

Answer 11

dilated cardiomyopathy

Question 12

Dilated cardiomyopathy

Answer 12

a condition in which poor systolic function is further compromised by dilated left ventricular walls that are unable to relax

Question 13

Compensatory mechanisms that occur in HF

Answer 13

1. Ventricular dilation
2. ventricular hypertrophy
3. Increased SNS stimulation
4. Neurohormonal response

Question 14

Dilation

Answer 14

enlargement of the chambers of the heart

Question 15

dilation occurs when?

Answer 15

when pressure in the LV is elevated over a long period of time

Question 16

Hypertrophy

Answer 16

increase in the muscle mass and cardiac wall thickness in response to to overwork and strain of chronic HF

Question 17

Ventricular remodelling

Answer 17

occurs after an MI. Changes in ventricular shape cause impaired contractility

Question 18

_____ sided heart failure is the most common form

Answer 18

Left sided

Question 19

Left sided heart failure results from

Answer 19

LV dysfunction causing blood to back up through the left atrium into the pulmonary veins

Question 20

What would you hear with left sided heart failure?

Answer 20

Coarse crackles

Question 21

What is the primary cause of right sided heart failure?

Answer 21

left sided heart failure

Question 22

Right sided heart failure causes

Answer 22

backward blood flow into the right atrium and into venous circulation

Question 23

Results of right sided HF

Answer 23

edema, heptomegaly, JVD and acites

Question 24

What is the hallmark sign of right sided HF?

Answer 24

peripheral edema

Question 25

Pulmonary edema

Answer 25

an acute life threatening situation where the alveoli become filled with serous fluid as a result of LV failure secondary to MI

Question 26

Clinical manifestations of pulmonary edema

Answer 26

anxious, pale, cool, clammy, severe dyspnea, accessory muscle use, increased resps, pink frothy sputum, rapid HR, elevated BP and orthopnea

Question 27

Treatment for pulmonary edema

Answer 27

high fowlers position, O2 by mask, cardiac monitoring and pulse ox

Question 28

Drug therapy for pulmonary edema

Answer 28

Morphine, IV diuretics, IV nitro, inotropic support

Question 29

Goal of therapy for pulmoanry edema?

Answer 29

decrease intravascular volume

Question 30

Sudden weight gain of ____ in ____ days is often indicative of exacerbated HF

Answer 30

2 kg in 2 days

Question 31

what can be used to decrease fluid volume

Answer 31

loop diuretics such as furosemide (Lasix)

Question 32

How do diuretics help in HF?

Answer 32

by decreasing venous return to the LV, thereby reducing preload, the overfilled left ventricle may contract more efficiently and improve CO

Question 33

HF patients should follow a ______ sodium diet

Answer 33

2 mg

Question 34

Foods that HF patients should avoid

Answer 34

milk, cheese, bread, cereals, canned soup, canned veggies and processed foods

Question 35

fluid restriction for HF patients

Answer 35

1.5 - 2 L per day