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Med Surg II > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

heart failure

A

complex clinical syndrome resulting in insufficient blood supply/oxygen to tissues and organs

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2
Q

decreased cardiac output results in

A

decreased tissue perfusion which decreases ejection fraction

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3
Q

primary risk factor for heart failure

A

hypertension (can be reduced by 50% if aggressively treated)

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4
Q

etiology of heart failure

A

any interference with mechanisms regulating cardiac output

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5
Q

primary causes of heart failure

A

conditions that directly damage the heart

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6
Q

precipitating causes of heart failure

A

conditions that increase the work load of the heart

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7
Q

possible conditions that increase work load of the heart

A

MI, valve damage, viral infection, cardiomyopathy

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8
Q

classification of left sided heart failure

A

results from inability of left ventricle to empty adequately during systole (working) or fill adequately during diastole (relaxing); bloods back up into left atrium

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9
Q

what occurs from left sided heart failure

A

increase in pulmonary hydrostatic pressure causing fluid leakage from the pulmonary bed into the interstitium and then the alveoli. this results in pulmonary congestion and edema

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10
Q

clinicial manifestations of left sided heart failure

A

decreased cardiac output and pulmonary edema

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11
Q

decreased cardiac output s/s

A

fatigue, weakness; oliguria during the day (nocturia at night); angina, confusion, restlessness; dizziness, tachycardia, palpitations; pallor, weak peripheral pulses, cool extremities

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12
Q

pulmonary congestion s/s

A

hacking cough, worse at night; dyspnea/breathlessness; crackles or wheezing in lungs; frothy, pink-tinged sputum, tachypnea

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13
Q

right-sided heart failure

A

right ventricle doesn’t pump effectively; this causes fluid to back up into the venous system which moves into the tissues and organs

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14
Q

clinical manifestations of right-sided heart failure

A

systemic congestion

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15
Q

systemic congestion s/s

A

jugular vein distention; enlarged liver and spleen; anorexia and nausea; dependent edema (legs and sacrum); distended abdomen; swollen hands and fingers; polyuria at night; weight gain

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16
Q

what is special about blood pressure r/t systemic congestion

A

increased is from excess volume; decreased is from failure

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17
Q

chronic heart failure clinical manifestations

A

fatigue, dyspnea, orthopnea, nocturnal dyspnea; cough, tachycardia, palpitations, edema; changes in urine output; nocturia, skin changes; neurological manifestations; mental status, behavior changes, and sleep problems; chest pain; weight changes

18
Q

diagnostic studies of heart failure

A

determine and treat underlying cause; echocardiogram; BNP levels; ECG, ambulatory heart monitors, MRI, cardiac catheterization, angiogram

19
Q

what does an echocardiogram show

A

provides information on left ventricle ejection fraction, heart value, presence of effusion or thrombus

20
Q

interprofessional care for heart failure

A

continuous monitoring and assessment; high-fowler’s position; hemodynamic monitoring if unstable; supplemental O2, BiPaP; mechanical ventilation if unstable; mechanical cardiac assist devices for patients with deteriorating heart failure; oxygen therapy; physical and emotional rest; structured exercise program; drug therapy

21
Q

mechanical cardiac assist devices

A

intraortic balloon pump (IABP) and ventricular assist devices (VADs)

22
Q

what does oxygen therapy help with heart failure

A

relieves dyspnea and fatigue

23
Q

what is important about physical and emotional rest for heart failure

A

conserve energy and decrease oxygen needs; dependent on severity of heart failure

24
Q

nutritional therapy for heart failure

A

low sodium diet; fluid restriction for stage D heart failure; daily weights

25
Q

low sodium diet for heart failure

A

individualize recommendations and consider cultural background; Na restricted to 2g/day

26
Q

warnings of weight gain r/t heart failure

A

weight gain of 3lbs (1.4kg) over 2 days or a 3-5lbs (2.3kg) gain over a week should be reported to HCP

27
Q

nursing assessment for heart failure

A

past health history; drugs; risk factors; nutritional history; subjective and objective data

28
Q

nursing diagnoses for heart failure

A

impaired gas exchange; impaired cardiac output; fluid imbalance; activity intolerance

29
Q

goals for heart failure

A

decrease in symptoms and peripheral edema; increase in exercise tolerance; adherence in exercise tolerance; no complications r/t heart failure

30
Q

nursing interventions r/t heart failure

A

health promotion; monitor respiratory status, hemodynamic status, daily weights, I&O, edema; semi-fowler’s position; administer drugs; collaborate; reduce anxiety; alternate rest and activity; patient teaching

31
Q

ambulatory care r/t heart failure

A

transitional care programs: comprehensive discharge planning, collab among providers, follow-ups with HCP

32
Q

patient teaching r/t heart failure

A

indications for worsening/recurrent heart failure; drug therapy; home BP monitoring

33
Q

what are some indications for worsening/recurrent HF?

A

rapid weight gain; decreased exercise tolerance; cold symptoms; excessive nocturia; development of dyspnea/angina at rest; increased edema in feet, ankles, and hands

34
Q

what are some expected outcomes of HF?

A

maintain adequate O2/CO2 exchange to meet O2 needs of the body; maintain adequate blood pumped by the heart to maintain metabolic needs; reduction/absence of edema and stable baseline weight; achieve a realistic program of activity that balances with energy conserving activities

35
Q

heart failure complications

A

pleural effusion; dysrhythmias and dyssynchronous contraction; hepatomegaly; cardiorenal syndrome; anemia

36
Q

pulmonary edema clinical manifestations

A

anxious, pale, cyanotic; dyspnea, orthopnea, tachypnea; paroxysmal nocturnal dyspnea, use of accessory muscles; cough with frothy, blood0tinged sputum; crackles and wheeze, tachycardia; hypotension and hypertension; abnormal S3 or S4 on ECG

37
Q

nursing actions for pulmonary edema

A

high-fowler’s position; oxygen; mechanical ventilation; IV meds (diuretics and morphine)

38
Q

pericardial tamponade

A

fluid accumulation in the pericardial sac

39
Q

pericardial tamponade symptoms

A

hypotension, muffled heart sounds, jugular vein distention

40
Q

pericardial tamponade nursing actions

A

IV fluids, notify provider, connect patient to a monitor

Med Surg II (9 decks)

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