Final Exam: Heart Failure Flashcards
(27 cards)
Normal EF:
> 55
Most common form
Results from left ventricular dysfunction
Blood backs up into left atrium and pulmonary veins
left sided HF
manifestations of left sided HF
Increased pulmonary pressure causes fluid leakage pulmonary congestion and edema
Right ventricular dysfunction
Blood backs up into the right atrium and venous circulation
r. sided HF
right sided most often caused by
l. sided HF
manifestations of r. sided HF
Jugular venous distention
Hepatomegaly, splenomegaly
Vascular congestion of GI tract
Peripheral edema
Impaired ability of the ventricles to relax and fill during diastole, resulting in decreased stroke volume and CO
diastolic HF
Heart failure with normal EF
Result of left ventricular hypertrophy from hypertension, MI, valve disease, or cardiomyopathy
PULMONARY CONGESTION
diast.
Inability to pump blood forward Caused by: Impaired contractility (MI) Increased afterload (HTN) Cardiomyopathy Mechanical abnormalities (valvular heart disease) decreased EF (5-10%)
systolic HF
in systolic HF, Left ventricle is
hypertrophied and dilated
in diastolic HF, left ventricle is
stiff and non-compliant
BIG difference between systolic and diastolic HF
diastolic has normal EF
Released in response to increased blood volume in heart
Causes diuresis, vasodilation, and lowered BP
natriuretic peptides
Released from the vascular endothelium in response to compensatory mechanisms
________ relaxes arterial smooth muscle, resulting in vasodilation and decreased afterload
nitric oxide (NO)
early stages of Acute decompensated Heart failure (ADHF)→
increased pulmonary venous pressure (LV failure)
Increase in the respiratory rate
Decrease in PaO2
Late stages s&s of ADHF
Later → interstitial edema
Tachypnea
S&S of pulmonary edema
Anxious/pale/cyanotic Cold/clammy skin Dyspnea/orthopnea JVD Tachypneic >30/minute Use of accessory muscles Cough with frothy, blood-tinged sputum Crackles, wheeze, rhonchi Tachycardia BP: high or low Abnormal S3 or S4
nursing care for adhf pt:
Continuous monitoring and assessment: VS, O2 saturation, urinary output Hemodynamic monitoring if unstable Supplemental oxygen Mechanical ventilation if unstable High Fowler’s position
for patients with volume overload and resistance to diuretics
ultrafiltration (aquaphoresis)
collaborative care for adhf pt: drugs
treat volume overload: lasix
treat blood volume overload: vasodilator (nitro, nesiritide)
treat pain, anxiety, dyspnea (morphine)
dopamine
FACES acronym for chronic heart failure
Fatigue Activities limited Chest congestion/cough Edema Shortness of breath
other signs & symptoms of chronic heart failure
fatigue, dyspnea, paroxysmal nocturnal dyspnea, tachycardia, edema, sudden wieght gain >3 lbs in one week indicates exacerbation ADHF, nocturia, skin changes, behavioral changes, weight changes, chest pain
drug therapy for chronic HF
diuretics (can cause hypokalemia), RAAS inhibitors (ace inhibitors, can cause hyperkalemia), beta blockers, vasodilators (nitrates–>no viagra, cialis), digitalis
diet for chronic HF
dash diet, limit sodium 2 gm/day, no fluid restriction, daily weights,
if weight gain 3 lb over 2 days, over 3-5 lbs over a week, tell doctor!
