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Heart Failure Flashcards

1
Q

What diseases can lead to HF?

A 
Cardiomyopathy
Valvular heart disease
Endocarditis
Acute MI
HTN
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2
Q

Left sided HF

What happens?

A

Blood doesnt move forward into aorta and out to body. If it doesnt move forward then it backs up to lungs

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3
Q

Left sided HF

What congestion?

A

Pulmonary

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4
Q

Left sided HF

Breathing

A

Dyspnea

Cough

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5
Q

Left sided HF

Sputum

A

Blood tinged frothy sputum

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6
Q

Left sided HF

Appearace

A

Restlessness

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7
Q

Left sided HF

Heart

A

Tachycardia

S3

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8
Q

Left sided HF

Sleep

A

Orthopnea (SOB when laying down–need to sleep propped up)

Nocturnal dyspnea (SOB/cough attacks at night)

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9
Q

Right sided HF

What happens

A

Blood destine move forward into lungs so it goes back into venus system

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10
Q

Right sided HF

Veins?

A

Distended neck veins

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11
Q

Right sided HF

Fluid?

A

Edema
Enlarged organs
Weight gain
Ascites

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12
Q

Systolic HF?

A

Heart can’t contract and eject

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13
Q

Diastolic HF?

A

Ventricles can’t relax and fill

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14
Q

BNP

How is it secreted?

A

Ventricular tissues in the heart when ventricular volumes and pressures in the heart are increased

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15
Q

BNP

Is it a sensitive indicator?

A

Yes

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16
Q

BNP

Can be ___ for HF when CXR does not indicate a problem

A

Positive

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17
Q

BNP

If the client is on nesiritide, turn it off ___ prior to drawing a BNP

A

2 hours

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18
Q

CXR will show what?

A

Enlarged heart, pulmonary infiltrates

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19
Q

What will echocardiogram show?

A

Looks at pumping action or EF of heart. Also gives info about back flow and valve disease

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20
Q

A balloon flotaton catheter than can be floated into the RIGHT side of the heart and pulmonary artery

A

Swan-Ganz (pulm. artery) catheter

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21
Q

What does Swan-Ganz do?

A

Provides info to rapidly determine hemodynamic pressures, CO, and provides access to mixed venous blood sampling

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22
Q

What is DOC for HF: ACE or ARB?

A

ACE (but ARB is used too)

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23
Q

Treatment: ACE (-pril)

What do they do?

A

Suppress RAS

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24
Q

Treatment: ACE (-pril)

Prevent conversion of ?

A

Angiotensin I to angiotensin II

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25
Treatment: ACE (-pril) Results in arterial ___ and ___ SV
Arterial dilation and increased stroke volume
26
Treatment: ACE (-pril) Reasons to stop an ACE?
Dry cough | Angioedema
27
Treatment: ARBs (-sartan) Block angiotensin II receptors and cause a ____ in arterial resistance and decreased BP
Decrease
28
Treatment: ARBs (-sartan) ACE and ARB both block ____. When we block this, what happens?
Block aldosterone * we loose NA and H20 * we retain K
29
Treatment: Digoxin Monitor for drug toxicity, esp in the __
Elderl
30
Treatment: Digoxin Used when the client is in sinus rhythm or a-fib and had accompanying ___
Chronic HF
31
Treatment: Digoxin Often given in combo with what?
ACE ARB BB or Diuretics
32
Treatment: Digoxin Contraction?
Increases
33
Treatment: Digoxin HR?
Decreases
34
Treatment: Digoxin When the HR is slowed, this gives the ventricles more time to fill with blood. Good for systolic or diastolic HF?
Diastolic HF
35
Treatment: Digoxin CO?
Increase
36
Treatment: Digoxin Kidney perfusion
Increase (UO goes up)
37
Would diuresis be a good thing or bad thing for this client?
Good
38
We always want to ___ HF clients
Diuresis
39
Normal level of Dig?
0.5-2
40
How do you know dig is working?
CO goes up
41
S/s of dig toxicity (early)?
ANorexia | NV
42
S/s of dig toxicity (late)?
Arrhythmias | Vision changes
43
Before giving dig, do what?
HR check
44
When to hold dig for infant, toddler, child, and adult?
Infant: Hold if 90-110 Toddler: Hold if less than 70 Child and adult: Hold if less than 60
45
Normal HR for infant? toddler? child? Normal RR for infant? toddler? child?
Infant: HR 140, RR 40 Toddler: HR 120, RR 30 Child: HR 100, RR 20
46
___ + Dig = toxicity
Potassium
47
T/F: ANy electrolyte imbalance can promote dig. toxicity
T
48
Treatment: Diuretics Action?
Decreases preload
49
Treatment: Diuretics When to give?
Morning
50
Why give low Na diet?
Decreases fluid retention and helps decrease preload *watch salt substitutes bc they contain excess potassium chloride
51
HOB?
Elevate
52
Weight
Daily and report weight gain of 2-3 lbs
53
Fluid retention think what first?
Heart problems | HF, pulm. edema
54
Your natural pacemaker is SA node or sinus node. It sends out impulses that make heart __. If your HR drops to 60 or below, CO can ____
``` Contract Be reduced (vital organs don't perfuse well though!) ```
55
Pacemakers are used to increase the HR with ____
Symptomatic bradycardia
56
Pacemakers depolarize the heart muscle and a contraction will occur (_____)
Electricity goes through the muscle
57
Repolarization is ?
When ventricles are resting and filling with blood
58
Always worry if HR drops below ___
Set rate
59
Any pacemaker will maintain a certain minimal HR depending on the settings aka the ___
Set rate
60
A demand pacemaker kicks in when?
When client needs it to
61
Fixed rate PM fire at ___
Fixed rate constantly
62
Its ok for the rate to increase but never ____
Decrease below set rate
63
Always worry if the rate ____ below set rate
Decreases
64
Post procedure care for PPM Monitor what? Most common complication? Arm? ROM?
- Monitor incision - Complication: Misplacement - Immobilize arm; keep client from raising arm higher than shoulder height (wires could come out) - Passive ROM to prevent frozen shoulder
65
S/S of PPM malfunction Failure to capture
No contraction will follow stimulus
66
S/S of PPM malfunction Failure to sense
Fire at inappropriate times
67
S/S of PPM malfunction What can cause loss of capture, failure to sense or any malfunction?
- May not be programmed correctly - Electrodes can dislodge - Battery may deplete
68
S/S of PPM malfunction Watch for sign of decreased CO or decreased __
Rate
69
Client edu/teaching for PM Check what daily? Need what? Avoid what? Airport?
Check HR daily Need ID card/bracelet Avoid electromagnetic fields (cell phones, large motors), MRI, and contact sports May set of alarm at airport
70
What is ICD? and why?
Implantable cardiac device (aka implantable cardioverter defibrillator) May be used to pace heart or defibrillate people in V-fib (post op care same as PM)

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