perfusion/circulation week 13 Flashcards

1
Q

heart failure

A

chronic progressive cardiac disorder often characterized by s/s of fluid overload and inadequate tissue perfusion
can be managed with lifestyle mods and medication

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2
Q

HF is most common in

A

people over 75

incidence increases with age

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3
Q

ejection fraction (EF)

A

a measurement of contractility

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4
Q

diastolic HF

A

stiff and noncompliant heart muscle

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5
Q

systolic HF

A

weakened heart muscle

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6
Q

left sided HF

A

left ventricle cannot effectively pump blood out of the ventricle into the aorta

extra heart sound (S3) caused by abnormal ventricular filling (AKA ventricular gallop)

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7
Q

left sided HF symptoms

A
pulmonary congestion, cough, orthopnea, paroxysmal nocturnal dyspnea (PND) - dyspnea at night
indigestion 2/2 decreased GI perfusion
dizziness, confusion, anxiety 
decreased CNS perfusion
palpitations
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8
Q

left sided HF signs

A

low o2 sats
extra heart sound (S3)
tan/pink frothy sputum from cough
pale, cool clammy skin

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9
Q

right sided HF s/s

A

increased venous pressure (JVD)
edema in lower extremities
hepatomegaly, ascites
weight gain

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10
Q

ACE inhibitors

A

promote vasodilation, diuresis
prevents progression of HF
may be first med prescribed for mild HF
-pril

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11
Q

angiotension receptor blockers (ARB)

A

alternative to ACE inhibitors
no cough side effect
-sartan

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12
Q

hydralazine and isosorbide dintrate side effect

A

symptomatic hypotension

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13
Q

beta blockers

A

prescribed in combination with ACE inhibitors; several weeks before effects

caution in asthma patients

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14
Q

beta blocker side effects

A

bradycardia
symptomatic hypotension
dizziness
fatigue

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15
Q

loop diuretics

A

decrease fluid volume
used for severe HF
side effects: electrolyte imbalances, renal dysfunction, decreased BP
monitor I&O, take daily weight

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16
Q

aldosterone antagonist

A

spironolactone
potassium-sparing diuretic
monitor for hyperkalemia, hyponatremia

17
Q

digoxin

A

improves cardiac contractility

monitor for bradycardia, toxicity

18
Q

milrinone

A

IV HF medication
decreases preload and afterload
side effects: hypotension, dysrhythmias

19
Q

dobutamine

A

IV medication for left ventricular dysfunction

increases cardiac contractility and renal perfusion

20
Q

gerontologic HF

A

may present with atypical s/s (fatigue, weakness, somnolence)
decreased renal function can make older patients more sensitive to volume changes and less responsive to diuretics
r/o urethral obstruction caused by urethral obstruction from enlarged prostate

21
Q

physical assessment of HF

A

mental status
lung sounds
heart sounds
fluid status

22
Q

goals for HF patient

A

promote activity
reduce fatigue
relieve fluid volume overload symptoms
decrease anxiety

23
Q

nursing dx: activity intolerance

A

bedrest for acute exacerbation
elevate head of bed to facilitate breathing
30-45 min daily activity
wait 2 hrs after eating for physical activity
avoid activity in extreme temperatures