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Pathophysiology Exam 2 > Chapter 20- ❤️ Failure & Circulatory Shock > Flashcards

Chapter 20- ❤️ Failure & Circulatory Shock Flashcards

(54 cards)

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1
Q

Functions of the heart

The heart moves __________________ blood from the venous system through the __________ ___________ into the ______________ circulation.

A
  • deoxygenated
  • right heart
  • pulmonary
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2
Q

The heart moves ______________ blood from the pulmonary circulation through the ________ heart into the _______ system.

A
  • oxygenated
  • left heart
  • arterial
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3
Q

Preload?

A

Amount of blood coming back to the heart

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4
Q

Afterload?

A

Amount of blood going out of each ventricle

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5
Q

Acute heart failure develops __________?

A

Rapidly

*immediately life threatening

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6
Q

Chronic Heart Failure is a condition associated with what?

A

The heart undergoing adaptive responses

  • adaptive responses can make heart failure worse*
  • most common today
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7
Q

Patients with cardiomyopathy ultimately need what?

A

A ❤️ transplant

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8
Q

Frank - Starling mechanism serves to do what?

A

To match the output of both ventricles

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9
Q

Frank - Sterling mechanism operates through what?

A

Increase preload

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10
Q

Frank-Starling mechanism can lead to what?

A

Ventricular wall tension

  • results in
    - increase in myocardial oxygen requirements leading to ischemia of the heart and further damage
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11
Q

Sympathetic reflexes are “_____ or _____”

A

Fight or flight

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12
Q

Sympathetic reflexes do what?

A
  • increase HR

- increase BP

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13
Q

What side of the ❤️ is the aortic valve on?

A

Left side

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14
Q

What side of the ❤️ is the mitral valve on?

A

Left side

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15
Q

Causes of left sided heart failure?

A
  • Acute myocardial infarction
  • Cardiomyopathy
  • Mitral valve regurgitation
  • Aortic valve stenosis and regurgitation

ALL LEFT SIDED
🤯🤯🤯

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16
Q

Signs and symptoms of left sided heart failure?

A
  • SOB
  • Dyspnea (due to fluid in the lungs)
  • Cyanosis
  • Paroxysmal nocturnal Dyspnea
  • Cheyne-stokes
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17
Q

Left sided heart failure affects the _________?

A

Lungs

Left- Lungs

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18
Q

Symptoms of left sided heart failure?

A
  • cough
  • crackles
  • wheezes
  • blood tinged sputum
  • Tachypnea
  • restlessness
  • confusion
  • orthopnea
  • tachycardia
  • exertional Dyspnea
  • fatigue
  • cyanosis
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19
Q

Why does left sided heart failure affect the lungs?

A

Backing up into VENTRICLES
(Ventricles can’t contain)

Flows into ATRIA
(Atria can’t contain)

Backflows into the lungs

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20
Q

What sound does fluid in the lungs produce?

A

Crackles

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21
Q

In patients with CHF

- sleeping flat= \_\_\_\_\_\_\_
- sleeping with multiple pillows/ in recliner = \_\_\_\_\_\_
A

Sleeping flat = Good

Sleeping w/multiple pillows/recliner = Bad

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22
Q

Right sided Heart Failure Signs and Symptoms?

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A
  • Fluid retention and edema
  • Fatigue and limited exercise tolerance
  • cachexia and malnutrition
    eat or breathe? —> patients would rather breath!
  • distention of the jugular veins in right sided HF
  • Diaphoresis and tachycardia
23
Q

Increased peripheral venous pressure is seen in what type of CHF?

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A

Right sided heart failure

24
Q

Ascites?

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A

Fluid in abdomen

25
Ascites is seen in what type of CHF?
Right sided heart failure
26
Enlarged liver and spleen is seen in what type of CHF?
Right sided CHF
27
Distended jugular veins = _____________ CHF?
Right sided
28
Anorexia and complaints of GI distress are seen with what type of CHF?
Right sided
29
Swelling in hands and feet is associated with what type of CHF?
Right sided
30
Dependent edema is seen in patients with what type of CHF?
Right sided CHF
31
Paroxysmal Nocturnal Dyspnea is seen in what type of CHF?
Left sided
32
Elevated pulmonary capillary wedge pressure is seen in what type of CHF?
Left sided CHF
33
Pulmonary congestion is seen in what type of CHF?
Left sided
34
Restlessness, confusion, fatigue are seen in what type of Congestive Heart Failure?
Left sided heart failure
35
What is Orthopnea?
Difficulty breathing when lying flat
36
Orthopnea, Tachycardia, Exertional Dyspnea, and Cyanosis are evident with what type of Congestive Heart Failure?
Left sided heart failure
37
What is the key diagnostic test to detecting fluid volume?
BNP ( Brain Natriuretic Peptide) * Great confirmation BECAUSE a chest x-ray showing fluid could be a number of different things such a pneumonia
38
What are 2 types of Circulatory shock?
Cardiogenic | Hypovolemic
39
Signs and symptoms of Cardiogenic shock?
INITIALLY - tachycardia - tachypnea - normal BP LATE - Cyanosis of lips, nail beds and skin - Decreased BP - Decrease urine output
40
Treatment for Cardiogenic shock?
- Oxygen | - Intra-aortic balloon pump
41
Hypovolemic shock is caused by what?
LOW VOLUME! *either blood loss or just fluid loss*
42
When do you start to see a decrease in BP and urine output in somebody with Hypovolemic shock?
35% to 45% blood loss
43
What is the standard urinary output an hour?
30mL an hour
44
What are the early signs and symptoms of Hypovolemic shock?
- Tachycardia - Tachypnea - Thirst ( using your fluid) - Restlessness (due to lack of O2 to the brain) - agitation
45
Parasympathetic Nervous System Does What?
Slowes everything down
46
What causes Neurogenic Shock?
Spinal cord injury above T6
47
What is the order of treatment for someone with Hypovolemic shock?
1. Crystalloids (.9 NS and Lactate Ringers)—> IV FLUIDS 2. Blood products 3. Vasopressures (Ex: norepinephrine, epinephrine)
48
What is the most severe systemic allergic reaction?
Anaphylactic Shock
49
Signs and symptoms of Anaphylactic shock?
- Rash - Urticaria (hives) - Dyspnea * Life Threatening* - Laryngeal edema and circulatory collapse
50
Treatment for Anaphylactic shock (epi pen) should always be given where?
In the thigh | most vascularity
51
Sepsis and septic shock signs and symptoms?
EARLY - Tachypnea - Tachycardia LATE - Hypotension - Warm and flushed skin - Decreased LOC - Decreased urinary output - Elevated serum lactate level - Metabolic acidosis
52
Treatment for Sepsis and Septic shock?
- Antibiotics (ASAP) | - Fluids
53
What does SIRS stand for?
Systemic Inflammatory Response
54
Sepsis is defined as?
Suspected or proven infection

Pathophysiology Exam 2 (6 decks)

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