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Cardiac Disorders
Cardiac Disorders- Chp 27-Heart Failure
| Question | Answer |
|---|---|
| What is heart failure? | The inability of the heart to function as a pump to meet the needs of the body |
| What are two classifications of HF? | Left sided HF and Right sided HF |
| Which ventricle is most often affected in HF? | The left ventricle due to the extra workload on the left side of the heart. |
| What is the forward and backward affect of left sided HF? | As the left ventricle fails, cardiac output falls (forward effect) Pressure is increased on the left side of the heart and in the pulmonary vascular system (backward effect)(643-Burke) |
| What is the outcome of backward effect of left sided HF? | Increased pressure pushes fluid into the alveoli and interstitial tissues |
| Name 9 S/S of left sided HF. | SOB, dyspnea, orthopnea cough, tachycardia, crackles in lung bases, activity intolerance, fatigue, weakness, dizziness |
| What is acute pulmonary edema? | Often an outcome of left sided HF. Accumulation of fluid in the interstitial spaces and alveoli causing acute dyspnea. Pulmonary edema is a medical emergency |
| What is the most common cause of right ventricular HF? | Left sided HF. |
| How does the left side cause the right side to fail? | The increase of pulmonary pressure |
| What happens in right sided HF | Blood flow from the right ventricle is impaired. The right ventricle and atrium becomes distended and blood accumulates in the systemic venous system. Venous pressure leads to abdominal organ congestion and peripheral tissue edema. |
| Name 7 S/S of right sided HF. | jugular vein distention, peripheral edema, anorexia/nausea, abdominal distention/ ascites, liver/spleen enlargement, fatigue, activity intolerance |
| What is biventricular failure? | when both left and right sides of the heart fail |
| What is paroxysmal nocturnal dyspnea (PND)? | Acute dyspnea that occurs at night when edema fluid that have accumulated during the day are released. Fluid overload takes place and pulmonary congestion |
| What is acute HF? | HF that occurs from damage to the heart muscle. (e.g. an MI) |
| What is chronic HF? | A long standing condition that develops gradually from conditions like hypertension or valve disease. |
| What two cardiac hormones are released from the heart muscle and are involved in fluid regulation? | Atrial natriuretic factor and B-type natriuretic peptide |
| How are these two hormones used to dx HF? | They increase in blood serum only in HF and no other heart condition. |
| Name 4 other tests used to dx HF. | chest x-ray, echocardiogram, and ECG |
| What would a chest x ray show that indicated possible HF? | vascular congestion and cardiomegaly |
| What would an echocardiogram show to indicate HF? | It can evaluate left ventricular function and assess ventricular dilation and hypertrophy |
| What would an ECG show to indicate HF? | ventricular enlargement, dysrhythmias, ischemia or infarct. |
| What four classes of meds are usually used to tx HF? | ACE inhibitors, diuretics, inotropic meds (drugs that increase heart contraction strength) and direct vasodilators |
| What is the drug of choice for tx acute pulmonary edema? | Morphine because it relieves anxiety, improves breathing and is a vasodilator. It also educes venous return and lowers left atrial pressure |
| What other meds are given by IV for acute pulmonary edema? | Loop diuretics such as Lasix to promote rapid diuresis |
| What herb is sometimes used to tx HF? | Hawthorne-it acts like an ACE inhibitor |
| What is a inotropic med used to tx HF? | Digitalis |
| What does it mean when it is said that digitalis has a "narrow therapeutic index"? | Levels of the drug that are therapeutic are close to being toxic |
| What are 6 early signs of digitalis toxicity? | anorexia, n/v, headache, alterations in vision dysrhythmias, and confusion. |
| What three electrolytes affect digitalis toxicity? | Low serum K and Mg which increases digitalis effect a well as high serum levels of Ca |
| What must the nurse assess before giving digitalis? | Assess heart rate by taking an apical pulse for 60 seconds. If it is less than 60 withhold the med and notify Dr. |
| What dietary restriction is needed for HF pts? | Salt, less than 1.5 -2 gr per day |
Created by:
3perfectcats
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