Chapter 35 Heart Failure

Question 1

How do you know the tx for ADHF is working?

Answer 1

when pt has decreased SOB

Question 2

What is PND?

Answer 2

Paraoxymal Nocturnal Dyspnea- wake upin the middle of the night feeling like they are suffocating, caused by reabsorption of fluid from dependant body areas

Question 3

What is the home care teaching for heart failure?

Answer 3

Health Promotion- Aggressively identify and treat risk factors, flu and pneumonia vaccine, education about diet, meals, exercise

Question 4

What foods are restricted on a 1 gram sodium diet?

Answer 4

No milk, cheese, bread, cereals, canned soups, canned veggies

Question 5

What is a BNP? What’s it used for in heart failure?

Answer 5

B type natriuretic peptide- differenitiates with either dyspnea is from HF. It is increased with left ventricular dysfunction

Question 6

What are the symptoms of ADHF?

Answer 6

Pulmonary edema, tachypnea, decreased PO2, SOB (even with mild activity), anxious, pale, clammy, cold skin, severe dyspnea, frothy blood tinged sputum, crackles/wheezes/rhonci, increased HR, BP variable. *Will see use of accessory muscles, RR >30, orthopnea, ALWAYS ASSESS LUNG SOUNDS AND MONITOR 02 STAT)

Question 7

What are the best medications for a patient with ADHF?

Answer 7

morphine, lasix, nitroglycerin, nipride, natrecor

Question 8

Inotropic Therapy

Answer 8

Improves contractility and also increases 02 need. Dont use as initial therapy for ADHF

Question 9

What are the symptoms of right-sided heart failure?

Answer 9

murmurs, heaves, JVD, edema, weight gain, ASCITIES, hepatomegaly, fatigue, nausea, anorexia, gi bleeding

Question 10

What are the symptoms of left-sided heart failure?

Answer 10

S3/S4, heaves, hypoxia, crackles/pleural effusion, dyspnea, restlessness, confusion, fatigue, PND/ORTHOPNEA, cough, FROTHY PINK TINGED SPUTUM

Question 11

What is FACES and what is it used for?

Answer 11

Fatigue, weakness, dizziness, fainting
Activities, needing to be limited
Chest congestion/cough
Edema
Shortness of breath
*know worsening of heart failure

Question 12

What is the purpose of daily weights for heart failure patients? What does a weight gain indicate?

Answer 12

see how much fluid they’re holding. 3 lbs in 2 days or 3-5 lbs in 1 week

Question 13

Complications of HF- pleural effusion, dysrhythmias, left ventricular thrombus, hepatomegaly, renal failure

Answer 13

Pleural effusion: from increased pressure in the pleural capillaries
Dysrythmias: usually atrial fibrillation which promotes clot formation in the atria which can increase risk of stroke (need anticoagulants)
LVT- can increase risk of stroke
Hepatomegaly- liver gets congested w/venous blood and can lead to cirrhosis
Renal Failure: from decreased perfusion of the kidneys

Question 14

Ejection Fraction

Answer 14

Distinguishes between systolic and diastolic HF. Normal is 60-75%. Important to know in terms of treatment