Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Disease 2 > CHF > Flashcards

CHF Flashcards

1
Q

Describe cardiogenic pulmonary edema

A

An abnormal, diffuse and extravascular accumulation of fluid in the pulmonary tissues and air spaces that arises with changes in hydrostatic forces associated with left sided heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is heart disease ranked as a cause of death in the US?

A

1

Accounts for 1 in 7 deaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some of the difference between cardiogenic pulmonary edema and non-cardiogenic pulmonary edema (ARDS)?

A

Non-cardiogenic pulmonary edema is the result of the immune system attacking the body
Cardiogenic edema is a result of increased hydrostatic forces in the pulmonary capillaries
Non-cardiogenic edema generates exudate
Cardiogenic edema generates transudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the basic gist of what is happening in the heart that results in pulmonary edema

A

The left ventricle fails to move blood forward
Pressure in the left ventricle increases
Because pressure in the left ventricle increased, blood from the left atrium cant get in completely so the pressure in the atrium grows
The blood in the pulmonary circulation gets backed up as a result
Pulmonary capillaries act as a relief valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the normal systolic pressure in the pulmonary capillaries?

A

10-15 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the normal capillary oncotic pressure?

A

25-30 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens when pulmonary arterial pressure exceeds 30 mmHg?

A

When PAP exceeds capillary oncotic pressure, the balance tips and fluid is pushed out of the capillaries and is not pulled back in by the oncotic pressure resulting in pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Do red blood cells affect oncotic pressure?

A

No, since the hemoglobin protein is inside the cell wall of the RBC, they do not affect oncotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some causes of heart failure?

A

CAD
Arrhythmias
Myocarditis
Acute valve dysfunctions
Cardiomyopathy
Hypertension that isnt controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two “flavors” of heart failure?

A

Heart failure with reduced ejection fraction
Heart failure with preserved ejection fraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is heart failure with preserved ejection fraction as called?

A

Diastolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe what has happened in HFrEF

A

The left ventricle has suffered something that has resulted in reduced contractility and can no longer move the normal amount of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does an ejection fraction of >70% indicate?

A

Hyperdynamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can you estimate LVEF?

A

By using an echocardiogram to estimate heart function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe what is happening in HFpEF

A

The fraction of the left ventricular volume being ejected is preserved
But the total volume of the left ventricle is reduced because the ventricle is failing to fully relax after systole so it cant be completely refilled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the normal range for ejection fraction?

A

50-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does an ejection fraction of 40-49 indicate?

A

Mild dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What ejection fraction constitutes a mild dysfunction

A

40-49%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does an ejection fraction of 30-39% indicate?

A

Moderate dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What ejection fraction constitutes moderate dysfunction?

A

30-39%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does an ejection fraction of <30% indicate?

A

Severe dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What ejection fraction constitutes a severe dysfunction?

A

<30%

22
Q

How can pulmonary edema affect surface tension?

A

Fluid shifting into the interstitium can lead to a swelling of the interstitium resulting in a decreased radius which results in a greater surface tension

23
Q

T/F: Pulmonary edema can disrupt surfactant production

A

True

24
Q

You suction a patient and see frothy pinkish white secretions. What is causing this and why is the sputum frothy?

A

Pulmonary edema
Surfactant is causing the sputum to be frothy, red blood cells are causing the sputum to be pink

25
Q

What could you see in a patient who is going into shock as a result of pulmonary edema?

A

Low blood pressure
Obtunded
Extremities mottled, cool, clammy
Poor capillary refill

25
Q

You auscultate a patient with cardiogenic pulmonary edema, what can you expect to hear?

A

Fine crackles that start at the lung bases and move up and coarsen as edema grows more severe
Wheezes
Rhonchi
Potential heart murmurs

26
Q

What might you observe when examining a patient who is experiencing pulmonary edema?

A

Diaphoresis
Nasal flaring
Cough
Intercostal retractions
Supraclavicular retractions
Cynanosis
Enlarged tender liver

27
Q

Describe paroxysmal nocturnal dyspnea

A

Shortness of breath at night due to fluid shift from the lower extremities resulting in a pulmonary edema and the need to sleep more upright
Patients usually know about this, ask them if they sleep sat up at night

28
Q

What hemodynamic indices could indicated cardiogenic pulmonary edema

A

Increased RAP
Increased PAP
Increased PWCP
Decreased CO
Increased PVR

29
Q

What does PCWP allow us the approximate?

A

Pressure in the left atrium

30
Q

Increased pressure in the circulatory system places strain on the walls of the heart resulting in the release of what?

A

BNP B-type natriuretic peptide

31
Q

What does BNp do?

A

Triggers a release of sodium by the kidneys which will cause fluid to follow the sodium and be removed from the body in

32
Q

What does BNP greater than 100 pg/dl indicate?

A

Suggests congestive heart failure

33
Q

What can testing a patients troponin levels tell us?

A

Whether or not they have had a myocardial infarction

34
Q

What can testing BUN and creatinine tell us?

A

Whether or not the kidneys are adequately perfused

35
Q

What would we see on a chest radiograph of a patient with cardiogenic pulmonary edema?

A

Bilateral fluffy opacities
Dilated pulmonary arteries
Left ventricular hypertrophy
Kerley A and B lines
Batswing or butterfly pattern
Pleural effusion

36
Q

What would you see on the chest radiograph of a patient with moderate left heart failure?

A

Cardiomegaly
Engorgement of pulmonary artery
Kerley A and B lines

36
Q

Bats wing or butterfly pattern is an indication of what?

A

CHF

37
Q

What would you see on the chest radiograph of a patient with mild left heart failure?

A

Pulmonary venous congestion with dilated pulmonary arteries

38
Q

What do Kerley A lines represent?

A

Deep interstitial edema that radiate out from the hilum into the central portions of the lungs

39
Q

Where would you see kerley A lines on a CXR?

A

Most prevalent in the middle and upper lung regions
Do not reach pleura

40
Q

Describe kerley B lines

A

Short thin horizontal lines of interstitial edema that extend inward from the pleural surface

41
Q

Where are Kerley B lines found?

A

Most commonly seen in lung bases
Can be seen throughout the lung

42
Q

What would you expect to see on the CXR of a patient with severe left CHF?

A

Cardiomegaly
Pulmonary artery engorgement
Interstitial pulmonary edema
Fluffy patches of pulmonary edema
Bats wing pattern

43
Q

Why is supplemental oxygen not necessarily recommended in patients with CHF?

A

Causes systemic vasoconstriction
Causes pulmonary vasodilation

44
Q

How does CPAP affect preload?

A

Decreases preload by reducing venous return by introducing positive pressure in chest

45
Q

What type of ventilation is typically used to treat people with CHF?

A

CPAP

46
Q

How does CPAP affect gas exchange?

A

Improves gas exchange by reducing the thickness of the alveolar walls

47
Q

What are the advantages of CPAP for patients with CHF?

A

Reduced venous return
Decrease alveolar collapse
Reduce vascular congestion
Improve gas exchange
Reduce WOB

48
Q

What are the common meds used to diurese patients?

A

Furosemide (lasix)
Bumetanide
Torsemide

49
Q

What medications are typically used to treat preload?

A

Nitroglycerin
Morphine sulfate

50
Q

What medications are typically used to reduce afterload?

A

Nitroprusside

51
Q

What medications would be used for chronic management of CHF?

A

Ace inhibitors
Angiotensin 2 receptor blockers
Diuretics
Antiarrhythmic medication

Disease 2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions