10 minute topic Heart failure Flashcards Preview

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Flashcards in 10 minute topic Heart failure Deck (34):
1

Heart failure

cardiac muscle is unable to pump effectively and unable to maintain adequate circulation to meet tissue needs

2

Result of HF

inadequate cardiac output
myocardial hypertrophy
pulmonary/systemic congestion

3

Causes of HF

can be acute or chronic
HTN, MI, Pulmonary HTN, dysrhythmias, valve disease, pericarditis, cardiomyopathy

4

Class I HF

Client exhibits no symptoms with activity

5

Class II HF

Client has symptoms with ordinary exertion

6

Class III HF

Client displays symptoms with minimal exertion

7

Class IV HF

Client has symptoms at rest (SOB and chest pain at rest)

8

Low-output heart failure

can initially occur on either the left or right side of the heart

9

Left sided (ventricular) HF

results in inadequate left ventricle (cardiac) output and inadequate tissue perfusion

10

Systolic failure

ejection fraction below 40%, pulmonary and systemic congestion

11

Diastolic failure

inadequate relaxation or “stiffening” prevents ventricular filling

12

Right Sided (ventricular) HF

inadequate right ventricle output and systemic venous congestion (peripheral edema)

13

Risk Factors for Left-sided (ventricular) HF (left = lungs)

Hypertension
Coronary artery disease
Angina
MI
Valvular disease (mitral and aortic)

14

Risk Factors for right-sided (ventricular) HF

Left-sided heart (ventricular) failure – it backs up to the right
Right ventricular MI
Pulmonary problems (COPD, pulmonary fibrosis)

15

Risk factors for high output HF

Increased metabolic needs
Septicemia (fever)
Anemia
Hyperthyroidism

16

Risk factors for cardiomyopathy

Coronary artery disease
Infection or inflammation of the heart muscle
Various cancer treatments (cause)
Prolonged alcohol use
Heredity

17

Cardiomyopathy sx

Fatigue
Weakness
Heart failure
Heart block
Gallop
Cardiomegaly

18

Human B-type natriuetic peptides (hBNP)

used to Dx HF from other respiratory problems and to monitor effectiveness of tx

19

Human B-type natriuetic peptides (hBNP) levels

100 < 300 pg/mL suggest HF is present.
> 300 pg/mL indicates mild HF
> 600 pg/mL indicates moderate HF
> 900 pg/mL indicates severe HF

20

Hemodynamic monitoring

done in the ICU to dx HF

21

Cardiac ultrasound or ECG

measures both systolic & diastolic function of the heart

22

Left ventricular ejection fraction (LVEF)

The volume of blood pumped from the left ventricle into the arteries upon each beat. Normal is 55% to 70%

23

Right ventricular ejection fraction (RVEF)

The volume of blood pumped from the right ventricle to the lungs upon each beat. Normal is 45% to 60%.

24

HF nursing care

Position to maximize ventilation (high fowlers, sit them up)
Bedrest until stable
Fluid and Na+ restrictions
Provide O2

25

HF medications

preload and afterload reducing agents
Inotropic agents
Vasodilators
Anticoagulants
hBNP

26

Medication to reduce preload

diuretics

27

Medication to reduce afterload

ACE inhibitors, ARBs to help the heart pump more easily by altering the resistance to the contraction

28

Inotropic agents

digoxin which will increase contractility and increase cardiac output

29

Vasodilators

will help to reduce preload and afterload and decrease myocardial demand (Nitro)

30

Anticoagulants

Coumadin – especially if they have a history of thrombus formation

31

nesiritide (Natrecor)

hBNP
used to treat acute HF, it causes natriuresis (loss of NA and vasodilation)

32

hBNP – nesiritide (Natrecor)nursing considerations,

hypotension, VT & bradycardia – on monitor & close VS monitoring
BNP levels will rise while on med
Give in separate IV d/t incompatibility with other meds (HEPARIN)

33

Ventricular assist device (VAD)

surgically implanted mechanical pump that assists a heart that is too weak to pump blood through the body.

34

Heart transplantation

End stage HF patients get this
The new hearts will often develop CAD
Will need increased K+ intake