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MedSurge 3 > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What are the typical causes of left sided HF?

A

htn, CAD, valvular disease

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2
Q

s/s of left sided HF

A

paroxysmal nocturnal dyspnea
orthopnea
crackles
wheezes
restlessness
exertional dyspnea
oliguria

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3
Q

what are the subtypes of left sided HF?

A

systolic and diastolic

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4
Q

what is systolic HF?

A

heart cannot contract forcefully enough during systole to eject adequate amounts of blood into circulation
ejection fraction is less than 35%

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5
Q

what is ejection fraction?

A

percentage of blood ejected from heart during systole

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6
Q

what is a normal ejection fraction?

A

50-70%

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7
Q

What types of patients are candidates for an ICD?

A

pts with an ejection fracture less than 30%

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8
Q

What is diastolic HF?

A

HF with preserved left ventricular function
left ventricle cannot relax causing inadequate filling
ventricle has to work harder

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9
Q

What is Right sided HF?

A

right ventricle cannot empty properly
increased volume and pressure cause edema
i.e. pulmonary hypertension

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10
Q

clinical manifestations of right sided HF?

A

JVD
hepatomegaly
anorexia and GI distress
ascites
dependent edema
polyuria

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11
Q

what is high output HF?

A

cardiac output remains normal or above normal

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12
Q

what causes high output HF?

A

increased metabolic needs
septicemia
high fever
anemia
hyperthyroidism

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13
Q

What is BNP what does it test for?

A

produced and released by the ventricles as they stretch in response to fluid overload
how much fluid you are retaining

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14
Q

what is the BNP for no HF?

A

100 or less

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15
Q

BNP for mild HF

A

100-300

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16
Q

BNP for moderate HF

A

300-700

17
Q

BNP for severe HF

A

700 or more

18
Q

Risk factors for HF

A

smoking
obesity
family hx
HTN
drugs
valvular disease
DM
sleep apnea

19
Q

what is pulse alternans?

A

a weak pulse alternates with a strong pulse despite a regular heart rhythm

20
Q

What is stage A of HF?

A

people who are high risk

21
Q

What is Stage B HF?

A

Structural heart disease but no s/s

22
Q

What is stage C of HF?

A

Heart disease with signs of HF

23
Q

What is stage D of HF?

A

end stage heart failure
ICD is used until person can get a transplant

24
Q

What does Digoxin do?

A

Increase contractility
reduces HR
slows conduction thru AV node

25
Q

What are the s/s of Digoxin toxicity?

A

fatigue
dysrhythmias
PVCs
Anorexia

26
Q

What must you monitor when giving digoxin and why?

A

potassium bc hypokalemia can cause digoxin toxicity

27
Q

What is dobutamine?

A

beta blocker that increases contractility and and CO/perfusion

28
Q

difference between metoprolol tartrate and succinate?

A

Succinate is an XR
Tartrate is short acting

29
Q

what is cardiac resynchronized therapy?

A

uses a permanent pacemaker or combined with an implantable cardioverter/defibrillator
stimulates more synchronized ventricular contractions

30
Q

Ventricular Assist Device

A

directly assist the heart’s pumping

31
Q

what is a worse complication of HF?

A

pulmonary edema

32
Q

s/s of pulmonary edema

A

crackles
ALOC
tachycardia
reduced urinary output
cough with frothy, pink tinged sputum
cold, clammy skin

33
Q

Emergency interventions for pulmonary edema?

A

Position in high fowlers
give 100% oxygen
establish IV access
Give IV NTG
lasix 40-80 mg
Morphine 2-5 mg

34
Q

How fast can lasix be pushed?

A

1- 2 minutes to prevent ototoxicity

35
Q

why is morphine administered for pulmonary edema?

A

to reduce preload and decrease any anxiety and work of breathing

36
Q

what is the patient education for HF?
(Remember MAWDS)

A

avoid NSAIDS
medication compliance
stay active at your limit dont overdo it
daily weighing at the same time w/ same scale
limit fluid intake to 2L
sodium to 2-3g

37
Q

what are the s/s of worsening HF?

A

rapid weight gain 2-3 lbs overnight
decrease in exercise tolerance lasting 2-3 days
cough/ cold symptoms lasting more than 3-5 days
polyuria at night
increased angina or dyspnea
increased edema in feet, ankles, and hands

38
Q

Why do we give patients with HF ACEI?

A

ACE inhibitors cause arterial dilation and increased stroke volume and helps get rid of extra fluid

MedSurge 3 (28 decks)

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