Week 7: CHF

Question 1

CHF is a major cause of d___ and d___ after ____ due to non- adherence to the treatment plan and recommended ____ changes

Answer 1

Disability
Death
MI
Lifestyle

Question 2

Heart failure is common among __ ____ due use of certain ___. For example long term use of ______ for arthritis and other chronic pain can cause ____ and _____ retention. There may also be p____ _____ and increase the toxicity of ______ and A_____ ______.

Answer 2

Older adults
Drugs 
NSAIDs 
Fluid 
Sodium 
Peripheral vasoconstriction 
Diuretics 
ACE inhibitors

Question 3

The medication actos for ____ may cause ___ and ___ retention

Answer 3

Diabetics
Fluid
Sodium

Question 4

Primary risk factors for CHF

Answer 4

CAD

Advancing age

Question 5

Contributing risk factors

Answer 5

HTN 
DM
Smoking 
Obesity 
High serum cholesterol

Question 6

Heart failure is usually a complication of another ________ condition. When the heart is diseased it cannot adequately ___ enough ____ blood to to the rest of the body

Answer 6

Cardiopulmonary
Pump
Arterial

Question 7

____ blood carries oxygen and nutrients to vital organs, when these organs are not adequately _____ they may not function properly

Answer 7

Arterial

Perfused

Question 8

Heart fails to maintain circulation in blood as a result of impaired ___ functioning and/ or excessive _______ _____

Answer 8

Cardiac

Workload demands

Question 9

The heart will use various compensation mechanisms to maintain _____ _____

Answer 9

Cardiac output

Question 10

CHF is characterized by ____ dysfunction, reduced ____ _____, diminished _____ ___ _____, and shortened life expectancy

Answer 10

Ventricular
Exercise tolerance
Quality of life

Question 11

Heart failure occurs when the heart cannot maintain ___ ability. The most common precipitating factor is ____

Answer 11

Pumping

MI

Question 12

In CHF the ___ fails as there is less ____ ____ to eject blood from the ____ ventricle

Answer 12

CO
Contractile mass
Left

Question 13

When ___ and ___ decrease this results in less blood reaching the various organs , decreased ___ ____, f_____, l____, and mild ______

Answer 13

CO 
SV 
Cell function 
Fatigue 
Lethargy 
Acidosis

Question 14

In response to the decreased CO, the ____ is activated to increase ____ and inducing ____ in an effort to maintain normal ____ and ____ to vital organs

Answer 14

SNS
HR 
Vasoconstriction
Pressure 
Perfusion

Question 15

Back up and congestion develop as coronary demands of ____ and ___ are not met. This leads to the ____ from the ventricles being less than the ____ of blood. There is also congestion in ___ circulation draining into the affected side of the _____

Answer 15

Oxygen 
Glucose 
Output 
Input
Venous 
Heart

Question 16

With ____ sided heart failure, the ____ ventricle weakens and cannot empty, this leads to decreased CO to the ____ because there is a decreased renal blood flow, which stimulates the ____ in order to maintain BP

Answer 16

Left
Left
Body
RAAS

Question 17

When the ____ ventricle is not functioning properly, instead of blood going to perfuse the vital organs through the aorta, it backs up into the ____ vein. This will lead to __ congestion or _____

Answer 17

Left
Pulmonary
Pulmonary
Edema

Question 18

With ___ sided heart failure the ___ ventricle weakens and cannot empty leading to decreased ___. Because of the ____ ventricle is not functioning properly blood backs up into the systemic circulation via the ___ ____.

Answer 18

Right 
Right 
CO 
Right 
Vena cava

Question 19

Right sided heart failure leads to increased ___ pressure and results in edema in the ____, _____, and ___ cavity. Very high venous pressure can lead to distention of ___ ____ and ___ edema

Answer 19

Venous 
Legs 
Liver 
Abdominal 
Neck veins 
Cerebral

Question 20

Symptoms of right backup failure include ___ congestion, increased ____ ____ pressure, e____, h____, and a_______

Answer 20

Systemic 
Jugular venous 
Edema 
Hepatomegaly  
Ascites

Question 21

There are no significant sx of _____ forward failure. Decreased _____ may occur because of decreased __ of the ___ ventricle

Answer 21

Right
Oxygenation
Output
Right

Question 22

Sx of left forward failure include f___, decreased G____ _____ ____, impaired ____, c___ and D____

Answer 22

Fatigue 
Glomerular filtration rate
Digestion 
Confusion
Disorientation

Question 23

Causes of left sided heart failure include ____ HTN, ___, ____ dysfunction such as pulmonic valvular stenosis, which leads to pressure or volume ____ on the heart

Answer 23

Systemic
MI
Valvular
Overload

Question 24

Right sided heart failure in the absence of left sided heart failure is a result of ____ problems like ___ or ____ HTN. ____ ___ ____ syndrome may also cause right sided heart failure

Answer 24

Pulmonary
COPD
Pulmonary
Acute respiratory distress

Question 25

As the amount of blood ejected from the ___ ventricle diminishes, ____ pressure builds up in the ____ venous system and results in fluid filled ____ and ____ congestion, resulting in ____ and c_____

Answer 25

``` Left Hydrostatic Pulmonary Alveoli Pulmonary Dyspnea Caugh ```

Question 26

The patient in early heart failure describes cough as ___, occurring mostly at ___ and usually ______

Answer 26

Irritating Night Nonproductive

Question 27

Patient with More severe heart failure will have ____ ___ ___ sputum- a sign of life threatening ______. Auscultate for _____ or ____.

Answer 27

Frothy pink tinged Edema Crackles Wheezing

Question 28

____ inspiratory ___ and fine profuse ___ that repeat themselves from breath to breath and don't diminish on ____ may indicate heart failure

Answer 28

Late Crackles Crackles Coughing

Question 29

Crackles are produced by ____ fluid often first noted in the __ of the lungs, and spread ___ as the condition worsens. ____ indicate a narrowing of the ____ ___ caused by ____ pulmonary vessels. Adventurous sounds heart should be identified with location and if on expiration, inspiration or both

Answer 29

``` Intra-alveolar Base Upward Wheezing Bronchial lumen Engorged ```

Question 30

Orthoptera

Answer 30

Dyspnea in recumbent or flat position

Question 31

Patients with ___ may sleep with many pillows, upright in bed, or in a recliner

Answer 31

Orthopnea

Question 32

Patients with ____ have weakness or fatigue with ___ and ___ in arms and legs alongside weight gain

Answer 32

Edema Activity Heaviness

Question 33

DANGER

Answer 33

``` Dyspnea Anxiety Nocturnal parozysmal dyspnea Gain in weight Edema Respiratory distress ```

Question 34

Clinical manifestations of ____ sided heart failure as result of pulmonary congestion include d____, c___, c___, w___, b____ ___ sputum, and ___. In addition to forward flow, they have ___ and ____

Answer 34

``` Left Dyspnea Cough Crackles Wheezing Blood tinged Orthopnea Restlessness Confusion ```

Question 35

Right sided heart failure patient has increased ____ ___ ____ manifested as a____, enlarged ____ and ____ and ____ edema

Answer 35

``` Peripheral venous pressure Ascites Liver Spleen Peripheral ```

Question 36

Patients with heart failure retain ___ and ___. The best indicator of fluid balance is ____.

Answer 36

Sodium Water Weight

Question 37

2.2 lbs = ____ fluid

Answer 37

1 L

Question 38

History and physical will asses patient for ____ ____ and signs and symptoms. A blood test that can be done is the ___ ____ ___ (___). A c____ ____, e____, e___, and c____ ______ can also help diagnose

Answer 38

``` Risk factors B-type natriuretic peptide (BNP) Chest x Ray Echocardiography ECG Cardiac catheterization ```

Question 39

The BNP is common for diagnosing heart failure particularly ___ sided heart failure with __. It's a hormone released as body's response to ____ ___ either from right or left ventricular function

Answer 39

Left Dyspnea Decreased CO

Question 40

_________ ______Diagnose left and right sided-> typically the heart is enlarged representing ___ or _____. P____ _____ reflect _____ failure

Answer 40

``` Chest X-ray Hypertrophy Dilation Pleural effusion Biventricular ```

Question 41

_____ is the best tool for diagnosing heart failure. cardiac ___ changes, pericardial _____, ____ ____, and _____ ___ can be diagnosed using this ____ technique.

Answer 41

``` Echocardiography Valvular Effusion Chamber enlargement Ventricular hypertrophy Noninvasive ```

Question 42

_____ often reveals ___ because o2 does not diffuse easily thought the fluid filled ___. Respiratory ___ may occur due to hyperventilation. Respiratory ____ may occur due to ___ retention. Metabolic ___ may indicate accumulation of ____ ___ that comes with ____ o2 in the cells

Answer 42

``` ABGS Hypoxia Alveoli Alkalosis Acidosis Co2 Lactic acid Decreased ```

Question 43

Overall treatment of goal is to improve ___ ___ __ done by possibly ____ cause and ____ ___ to increase activity tolerance.

Answer 43

Quality of life Correcting Supplemental o2

Question 44

Medications for heart failure aim to improve ___, reduce __ ___ ___, decrease __ ___

Answer 44

CO Peripheral vascular resistance Fluid overload

Question 45

Possible medications for CHF

Answer 45

Ace inhibitors Diuretics Beta blockers Calcium channel blockers

Question 46

___ ___ are more affected than euro- Americans by CHF likely because they have more risk factors that lead to ____ and _____

Answer 46

African Americans HTN Diabetes