Week 7: CHF Flashcards
CHF is a major cause of d___ and d___ after ____ due to non- adherence to the treatment plan and recommended ____ changes
Disability
Death
MI
Lifestyle
Heart failure is common among __ ____ due use of certain ___. For example long term use of ______ for arthritis and other chronic pain can cause ____ and _____ retention. There may also be p____ _____ and increase the toxicity of ______ and A_____ ______.
Older adults Drugs NSAIDs Fluid Sodium Peripheral vasoconstriction Diuretics ACE inhibitors
The medication actos for ____ may cause ___ and ___ retention
Diabetics
Fluid
Sodium
Primary risk factors for CHF
CAD
Advancing age
Contributing risk factors
HTN DM Smoking Obesity High serum cholesterol
Heart failure is usually a complication of another ________ condition. When the heart is diseased it cannot adequately ___ enough ____ blood to to the rest of the body
Cardiopulmonary
Pump
Arterial
____ blood carries oxygen and nutrients to vital organs, when these organs are not adequately _____ they may not function properly
Arterial
Perfused
Heart fails to maintain circulation in blood as a result of impaired ___ functioning and/ or excessive _______ _____
Cardiac
Workload demands
The heart will use various compensation mechanisms to maintain _____ _____
Cardiac output
CHF is characterized by ____ dysfunction, reduced ____ _____, diminished _____ ___ _____, and shortened life expectancy
Ventricular
Exercise tolerance
Quality of life
Heart failure occurs when the heart cannot maintain ___ ability. The most common precipitating factor is ____
Pumping
MI
In CHF the ___ fails as there is less ____ ____ to eject blood from the ____ ventricle
CO
Contractile mass
Left
When ___ and ___ decrease this results in less blood reaching the various organs , decreased ___ ____, f_____, l____, and mild ______
CO SV Cell function Fatigue Lethargy Acidosis
In response to the decreased CO, the ____ is activated to increase ____ and inducing ____ in an effort to maintain normal ____ and ____ to vital organs
SNS HR Vasoconstriction Pressure Perfusion
Back up and congestion develop as coronary demands of ____ and ___ are not met. This leads to the ____ from the ventricles being less than the ____ of blood. There is also congestion in ___ circulation draining into the affected side of the _____
Oxygen Glucose Output Input Venous Heart
With ____ sided heart failure, the ____ ventricle weakens and cannot empty, this leads to decreased CO to the ____ because there is a decreased renal blood flow, which stimulates the ____ in order to maintain BP
Left
Left
Body
RAAS
When the ____ ventricle is not functioning properly, instead of blood going to perfuse the vital organs through the aorta, it backs up into the ____ vein. This will lead to __ congestion or _____
Left
Pulmonary
Pulmonary
Edema
With ___ sided heart failure the ___ ventricle weakens and cannot empty leading to decreased ___. Because of the ____ ventricle is not functioning properly blood backs up into the systemic circulation via the ___ ____.
Right Right CO Right Vena cava
Right sided heart failure leads to increased ___ pressure and results in edema in the ____, _____, and ___ cavity. Very high venous pressure can lead to distention of ___ ____ and ___ edema
Venous Legs Liver Abdominal Neck veins Cerebral
Symptoms of right backup failure include ___ congestion, increased ____ ____ pressure, e____, h____, and a_______
Systemic Jugular venous Edema Hepatomegaly Ascites
There are no significant sx of _____ forward failure. Decreased _____ may occur because of decreased __ of the ___ ventricle
Right
Oxygenation
Output
Right
Sx of left forward failure include f___, decreased G____ _____ ____, impaired ____, c___ and D____
Fatigue Glomerular filtration rate Digestion Confusion Disorientation
Causes of left sided heart failure include ____ HTN, ___, ____ dysfunction such as pulmonic valvular stenosis, which leads to pressure or volume ____ on the heart
Systemic
MI
Valvular
Overload
Right sided heart failure in the absence of left sided heart failure is a result of ____ problems like ___ or ____ HTN. ____ ___ ____ syndrome may also cause right sided heart failure
Pulmonary
COPD
Pulmonary
Acute respiratory distress
As the amount of blood ejected from the ___ ventricle diminishes, ____ pressure builds up in the ____ venous system and results in fluid filled ____ and ____ congestion, resulting in ____ and c_____
Left Hydrostatic Pulmonary Alveoli Pulmonary Dyspnea Caugh
The patient in early heart failure describes cough as ___, occurring mostly at ___ and usually ______
Irritating
Night
Nonproductive
Patient with More severe heart failure will have ____ ___ ___ sputum- a sign of life threatening ______. Auscultate for _____ or ____.
Frothy pink tinged
Edema
Crackles
Wheezing
____ inspiratory ___ and fine profuse ___ that repeat themselves from breath to breath and don’t diminish on ____ may indicate heart failure
Late
Crackles
Crackles
Coughing
Crackles are produced by ____ fluid often first noted in the __ of the lungs, and spread ___ as the condition worsens. ____ indicate a narrowing of the ____ ___ caused by ____ pulmonary vessels. Adventurous sounds heart should be identified with location and if on expiration, inspiration or both
Intra-alveolar Base Upward Wheezing Bronchial lumen Engorged
Orthoptera
Dyspnea in recumbent or flat position
Patients with ___ may sleep with many pillows, upright in bed, or in a recliner
Orthopnea
Patients with ____ have weakness or fatigue with ___ and ___ in arms and legs alongside weight gain
Edema
Activity
Heaviness
DANGER
Dyspnea Anxiety Nocturnal parozysmal dyspnea Gain in weight Edema Respiratory distress
Clinical manifestations of ____ sided heart failure as result of pulmonary congestion include d____, c___, c___, w___, b____ ___ sputum, and ___. In addition to forward flow, they have ___ and ____
Left Dyspnea Cough Crackles Wheezing Blood tinged Orthopnea Restlessness Confusion
Right sided heart failure patient has increased ____ ___ ____ manifested as a____, enlarged ____ and ____ and ____ edema
Peripheral venous pressure Ascites Liver Spleen Peripheral
Patients with heart failure retain ___ and ___. The best indicator of fluid balance is ____.
Sodium
Water
Weight
2.2 lbs = ____ fluid
1 L
History and physical will asses patient for ____ ____ and signs and symptoms. A blood test that can be done is the ___ ____ ___ (___). A c____ ____, e____, e___, and c____ ______ can also help diagnose
Risk factors B-type natriuretic peptide (BNP) Chest x Ray Echocardiography ECG Cardiac catheterization
The BNP is common for diagnosing heart failure particularly ___ sided heart failure with __. It’s a hormone released as body’s response to ____ ___ either from right or left ventricular function
Left
Dyspnea
Decreased CO
_________ ______Diagnose left and right sided-> typically the heart is enlarged representing ___ or _____. P____ _____ reflect _____ failure
Chest X-ray Hypertrophy Dilation Pleural effusion Biventricular
_____ is the best tool for diagnosing heart failure. cardiac ___ changes, pericardial _____, ____ ____, and _____ ___ can be diagnosed using this ____ technique.
Echocardiography Valvular Effusion Chamber enlargement Ventricular hypertrophy Noninvasive
_____ often reveals ___ because o2 does not diffuse easily thought the fluid filled ___. Respiratory ___ may occur due to hyperventilation. Respiratory ____ may occur due to ___ retention. Metabolic ___ may indicate accumulation of ____ ___ that comes with ____ o2 in the cells
ABGS Hypoxia Alveoli Alkalosis Acidosis Co2 Lactic acid Decreased
Overall treatment of goal is to improve ___ ___ __ done by possibly ____ cause and ____ ___ to increase activity tolerance.
Quality of life
Correcting
Supplemental o2
Medications for heart failure aim to improve ___, reduce __ ___ ___, decrease __ ___
CO
Peripheral vascular resistance
Fluid overload
Possible medications for CHF
Ace inhibitors
Diuretics
Beta blockers
Calcium channel blockers
___ ___ are more affected than euro- Americans by CHF likely because they have more risk factors that lead to ____ and _____
African Americans
HTN
Diabetes
