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From Flashcardlet > (3) Exam 3-❤️ Lecture #3- CHF > Flashcards

(3) Exam 3-❤️ Lecture #3- CHF Flashcards

0
Q

Congestive Heart Failure

How does CAD affect the heart?

A

Heart becomes ischemic and cant pump very well

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1
Q

Congestive Heart Failure

🚬 What are the risk factors for CHF?

A 
▪️CAD
▪️HTN
▪️Diabetes
▪️Smoking
▪️Obesity
▪️High Cholesterol
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2
Q

Congestive Heart Failure

How does HTN affect the heart?

A

Causes damage to the coronary arteries and causes vasoconstriction

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3
Q

Congestive Heart Failure

How does diabetes affect the heart?

A

Causes damage to the microvasculature of the heart and causes cells that are fed by the micovessels to die off in a small amount. Heart becomes weak

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4
Q

Congestive Heart Failure

How does smoking affect the heart?

A

Damages lining of the blood vessels by inflaming them and can also promote cell damage in the heart

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5
Q

Congestive Heart Failure

🚬 What are the most common causes of HF?

A

▪️MI
▪️HTN
▪️Valvular Disease

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6
Q

Congestive Heart Failure
💊 What type of drug prevents Angiotensin 2 from causing vasoconstriction and prevent aldosterone from causing sodium and water retention?

A

ACE Inhibitors

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7
Q

Congestive Heart Failure

HF usually occurs on what side of the heart first?

A

Left because it works harder

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8
Q

Congestive Heart Failure

😰 What is the first sign of decreased CO?

A

Confusion

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9
Q

Congestive Heart Failure

😰 What is the long term sign of decreased CO?

A

Decreased Urinary Output

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10
Q

Congestive Heart Failure

😰 What HF primarily has respiratory types of symptoms?

A

Left-Sided HF

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11
Q

Congestive Heart Failure

😰 What are the S/S of Left-Sided HF?

A 
▪️Dyspnea
▪️Orthopnea
▪️Proxysmal Nocturnal Dyspnea
▪️Cough
▪️Tachycardia
▪️S3, crackles
▪️Fatigue
▪️Anxiety / Restlessness
▪️Chest Pain
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12
Q

Congestive Heart Failure

😰 A dry that is initially present with L. Sided HF may progress to what?

A

Frothy, blood-tinged sputum which is evidence of pulmonary edema

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13
Q

Congestive Heart Failure

😰 When auscultating the lungs, when are crackles a sign that the patient may be having HF?

A

Crackles that doesn’t clear with a cough

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14
Q

Congestive Heart Failure
😰 With L. Sided HF, crackles are heard because the lungs are filling with fluid, but what sound is heard because the airways are swollen and filling with fluid?

A

Wheezes

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15
Q

Congestive Heart Failure

😰 What HF has peripheral S/S such as dependent edema, liver enlargement, and jugular vein distention?

A

Right Sided HF

16
Q

Congestive Heart Failure

🚬 What is the most common cause of R. Sided HF?

A

L. Sided HF

17
Q

Congestive Heart Failure

♿️ What HF occurs with a massive MI to the Right side or Cor Pulmonale?

A

R. Sided HF

18
Q

Congestive Heart Failure

😰 With R. Sided HF the liver will be tender and can be palpated in what quadrant?

A

RUQ

19
Q

Congestive Heart Failure

😰 What are the S/S of R. Sided HF?

A 
▪️Edema
▪️Hepatomegaly
▪️RUQ Pain
▪️Distended Neck Veins
▪️Anorexia / Nausea
▪️Fatigue
20
Q

Congestive Heart Failure

♿️ If the patient has chronic R. Sided HF, hepatomegaly can lead to what complication?

A

Ascites

21
Q

Congestive Heart Failure

😰 Edema is present when a sudden weight gain or loss of how much occurs within a 24 hr period?

A

2 kg = 4.4 lbs

22
Q

Congestive Heart Failure

💉 Stretching of the heart releases what amino acid that triggers the kidneys to release more sodium and water?

A

BNP

23
Q

Congestive Heart Failure

💉 What BNP value is considered abnormal and is suggestive of HF?

A

> 100

24
Q

Congestive Heart Failure

📈 What diagnostic studies can be used to diagnose or help diagnose HF?

A

▪️Chest X-Ray (Infiltrates & Cardiomegaly)
▪️ECG (Ischemia)
▪️2-D Echocardiogram (Ejection Fraction)
▪️Cardiac Catheterization (CVP-Central Venous Pressure)
▪️Nuclear Imaging (Heart Function

25
Q

Congestive Heart Failure

📈 When using Cardiac Catheterization to diagnose HF, what does it mean if there is elevated left / right heart pressure?

A

▪️Elevated L. heart pressure = L. Sided HF

▪️Elevated R. heart pressure = R. Sided HF

26
Q

Congestive Heart Failure

💊 What medications can be given for the treatment of HF?

A 
▪️Cardiac Glycosides (Digoxin)
▪️Diuretic Therapy
▪️Vasodilators (Nitroglycerin)
▪️ACE Inhibitors
▪️Beta Blockers
▪️Anticoagulants 
▪️Morphine Sulfate (Anxiety & Vasodilator)
▪️Positive Inotropes (Dobutamine)
27
Q

Congestive Heart Failure
💊 What Positive Inotrope drug used for the treatment of HF is for short term use, usually given via IV in ICU, and is titrated up and down depending on the patients S/S?

A

Dobutamine

28
Q

Congestive Heart Failure

🍓 What diet is recommended for patients with HF?

A

Low Sodium (2 G Sodium) & Small frequent meals

29
Q

Congestive Heart Failure

😷 How should activity and rest be planned for patients with HF?

A

Separate activities and interventions because they need breaks between. Do as much for them as they will allow because they more they do, they harder their heart is having to work.

30
Q

Congestive Heart Failure

💊 When would revascularization and stent placement be considered for patients in HF?

A

CAD Blockage

31
Q

Congestive Heart Failure

💊 What type of pacemaker can be used for the treatment of HF?

A

Biventricular Pacemakers

32
Q

Congestive Heart Failure

😷 Nursing interventions for patients in Acute HF and SOB?

A 
▪️Positioning 
▪️Decrease Anxiety
▪️Assess Lung & Heart Sounds
▪️Monitor VS, I&O, & Edema
▪️Daily Weights
▪️Progressive Ambulation
▪️Meticulous Skin Care
33
Q

Congestive Heart Failure

😷 What position does the patient in the acute phase of HF and SOB need to be placed in?

A

High Fowlers

34
Q

Congestive Heart Failure

💊 What medication can be used in small does to decrease anxiety in patients with Acute HF and SOB?

A

Morphine

35
Q

Congestive Heart Failure
😷 Meticulous skin care is needed in patients with HF because the skin is fragile and susceptible to breakdown and tears due to what interfering with gas exchange in the skin?

A

Edema

36
Q

Congestive Heart Failure

😰 Besides weight gain, when should the HCP with HF?

A

▪️Shoes fitting tighter than usual
▪️Nausea & Anorexia
▪️↓Activity tolerance lasting > 2-3 days (Easily exhausted from usual activity)
▪️Awakening at night SOB or to urinate, dizziness, angina

37
Q

Congestive Heart Failure

😰 What amount of weight gain in patients with HF does the HCP need to be notified?

A

Weight gain of 3 lbs in 2 days OR 3-5 lbs in a week

38
Q

Congestive Heart Failure

📚 What do you want to teach patients with HF?

A

▪️Hidden sources of sodium
▪️How to take their pulse if on Digoxin
▪️Weigh Self Daily
▪️Medication Administration- If untreated leads to cardiogenic shock which leads to death.

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