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N126-U3-I. MI/CHF#10
Dobrisky-CHF and pulmonary edema
Question | Answer |
---|---|
Heart failure is defined as | when the heart is unable to pump sufficient blood carrying oxygen and nutrients to adequately perfuse tissues |
Heart failure can be the result of what conditions | CAD, MI, HTN, COPD, hyperthyroidism, substance abuse, heart valve disease |
HTN can result in CHF due to what condition | cardiomegaly |
Hyperthyroidism and other metabolic alterations can lead to CHF as a result of an increase in what | CO |
Substance abuse can lead to CHF by causing what | cardiomyopathy and/or MI |
Acute Heart Failure is the most common reason for hospital admission in what age group | elderly |
Acute heart failure occurs rapidly with the onset of | severe signs and symptoms of failure |
Acute heart failure requires immediate treatment or it will lead to | cardiogenic shock |
Chronic failure can be treated with what | oral drugs, diet, exercise |
MI will lead to what sided CHF | left sided |
Left sided heart failure presents with what types of S/S | respiratory |
Right sided heart failure presents with what types of S/S | volume overload |
Fatigue, dyspnea, orthopnea, chest pain, anxiety and paroxysmal nocturanl dyspnea are all s/s of which type of failure | left sided |
Tachycardia is considered a compensatory mechanism for which type of heart failre | left sided |
Heart failure is classified from 1-4, 4 being | final stage |
What type of sputum can be expected from a pt with Left sided heart failure | pink or white, frothy sputum |
Describe cheyne-stokes respiration | slow to rapid then slow again and then stops momentarily |
Patients with left sided heart failure can be expected to where oxygen when | > at night and sometimes during the day |
Define orthopnea | SOB when lying flat |
Depended edema is associated with which type of heart failure | right sided |
Define cachexia | muscle wasting in arms and legs |
a pt with left sided heart failure may experience what type of changes in their BP | hypertension followed by hypotension and shock |
distended jugular veins are associated with what type of heart failure | right sided |
Which sided heart failure is considered to be a volume problem | right sided |
peripheral edema, ascites and JVD are all s/s of which type of heart failure | right sided |
Decreased bowel signs are associated with which side | right sided |
A BNP result of >100 is a classic sign of what condition | CHF |
What type of tests are done to determine the size of the heart and valve and chamber size | CXR & cardiac echo |
Nuclear ventriculography is used to visualize what | perfusion through the heart |
Angiography is also called | cardiac catheterization |
Cardiac enzymes, serum chemistry, liver enzymes, thyroid and CBC are all ordered to rule out what | MI |
What activity level is best to promote diuresis for these patients | bedrest |
if a patient has pulmonary edema what angle should the HOB be placed in | 90 degrees |
Cardioversion for A Fib may include what two methods | defibrillation and/or meds |
What dietary changes are expected to be ordered in a CHF pt | fluid restrictions, low Na |
a low sodium diet will help decrease the workload on the heart by promoting what | diuresis |
A CHF patient should be encouraged to eat what types of meals | frequent, small meals with adequate protein |
Diuretics, ACE inhibitors, beta blockers, digoxin and aldosterone antagonists are all used in the treatment of | heart failure |
What med will be administered to reduce fluid overload or preload | diuretics |
When administering diuretics, patients in diastolic failure, should be watched cautiously for what possible complication | extreme hypotension |
diastolic failure is a filling problem | |
systolic failure is a output problem | |
diastolic filling | |
systolic output | |
Losartin (Cozaar) preserves myocardium by preventing what | scar tissue |
Furosemide (Lasix) when given IV push, should be given at what rate per min | 1ml/min |
What vital sign should be monitored while administering Lasix | BP |
what two types of diuretics may be compbined for greater diuresis | loop & thiazide |
***Enalapril (Vasotec) is in what class of diuretics | ACE inhibitors |
What class of drug is essential for treating heart failure | ACE inhibitors |
Enalapril (Vasotec) elevates what in the blood | K+ |
what effect does Enalapril have on preoad & afterload and how | reduces both by vasodilating |
what three complications should be monitored for with Enalapril | hyperkalemia, hypotension, fluid depletion |
Losartin (Cozaar) is in what class of drug | diuretic, angiotensin receptor blocker |
beta blockers relieve CHF by | slowing heart rate and allowing for complete filling |
Carvedilol (Coreg) and Metoprolol (Lopressor) are in what class of drug | antidiuretic, beta blockers |
Beta blockers should be held if the systolic bp & hr are | sbp <90 and hr <60 |
Coreg or Lopressor are almost always given before what cardiac procedure | cardiac catheterization |
Calcium channel blockers should not be given to patients with what type of ventricular dysfunction | severe left ventricular dysfunction |
Norvasc is a | calcium channel blocker |
Digitalis is usually given if the pt has had no response to other drugs or | they are in Afib |
Hypokalemia has what effect on dig toxicity | enhances dig toxicity |
The first sign of dig toxicity is considered to be | anorexia |
yellow green halos around lights and confusion are both s/s of | dig toxicity |
What effect does dig have on the HR | slows the heart rate |
Negative chronotropic effect of dig is | slows the heart rate |
Negative dromotropic effect of dig is | slows conduction velocity |
beta blockers and calcium channel blockers when used with dig may enhance what effect of dig | bradycardia |
When administering aldosterone antagonists monitor for | hyperkalemia |
Nitrates and morphine decrease preload by | dilating veins, causing venous pooling |
To relieve dynea, elevate HOB | 45 |
To relieve pulmonary edema elevate HOB | 90 |
differentiate between inotropic, chronotropic and dromotropic | inotropic-contraction; chronotropic-rate; dromotropic-electrical |