Heart failure

Question 1

What is diabetic ketoacidosis? (DKA)

Answer 1

Body cannot use glucose as a food source because of limited or no insulin so fat is broken down to fuel the body. This process produces a blood up of blood acids called ketones.

Question 2

Clinical features of DKA?

Answer 2

dehydration, hyperglycaemia, acetone breath, electrolyte loss, acidosis

Question 3

Main cause of DKA?

Answer 3

Diabetic patient reduces their insulin dose if they are not eating. Illness/infection stimulate stress hormones to be released which promotes glycogen breakdown and glucose production in the liver, as well as insulin resistance in the muscle and fat tissue

Question 4

Sick day rules for a diabetic patient?

Answer 4

• if you cannot follow your usual meal plan substitute soft foods 6-8 times per day
• report elevated glucose levels or blood ketones to GP or diabetic educator
• report nausea,vomiting, and diarrhoea
• test blood glucose and ketones every 2-4 hours

Question 5

Which atrium receives the highest pressure?

Answer 5

Left atrium.

Question 6

What are the three types of heart failure?

Answer 6

1. Dilated cardiomyopathy
2. Restrictive/constructive cardiomyopathy
3. Hypertrophic cardiomyopathy

Question 7

Restricted/constructive cardiomyopathy

Answer 7

Left ventricular hypertrophy

Question 8

Dilated cardiomyopathy

Answer 8

increased atrial and ventricular chamber size, decreased muscle size

Question 9

Hypertrophic cardiomyopathy

Answer 9

decreased ventricular chamber size, left ventricular hypertrophy, and thickened inter ventricular septum

Question 10

Why would a patient with heart failure be put on a 1 l water restriction?

Answer 10

patient may experience fluid overload if they have a decreased ejection fraction %. This means the patient will be unable to circulate all the blood volume. Water intake is restricted to reduce the work load and odema.

Question 11

What is carvedilol used for?

Answer 11

• alpha and beta adrenergic receptor blocking agent

- it reduces peripheral and vascular resistance and lowers BP.

Question 12

What is frusomide used for?

Answer 12

• diuretic, used to treat odema associated with CHF

Question 13

Wafarin?

Answer 13

Anti-coagulant

Question 14

Cilazapril?

Answer 14

• angiotensin converting enzyme (ACE inhibitor)
• acts as a potent vasoconstrictor
• improves loading conditions in a failing heart