N130 OLOL Cardio III Exam II
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| A clinical syndrome characterized by s and s of fluid overload or of inadequate tissue perfusion? | Heart Failure
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| What is usually an acute presentation of HF? | CHF
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| What is the most common reason for hospitalization of people older than 65? | Heart failure
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| What is the 2nd most common reason for a visit to a physicians office? | Heart failure
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| What is wrong in diastolic heart failure? | something wrong with the ventricular filling
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| What is wrong in systolic heart failure? | something wrong with the ventricular contraction/pumping
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| Which occurs first, left sided or right sided heart failure? | left sided HF b/c blood backs up into the left atrium then into the lungs, which causes pulmonary edema.
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| Ejection fraction is normal in | diastolic HF
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| Ejection fraction is less than 40% in | systolic HF
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| Ejection Fraction | When the heart contracts it doesn't completly empty of blood, usually 60-70 %
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| The harder the heart works, the more ________ it needs | oxygen
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| co= | HR x SV
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| Preload is decreased by | diuretics
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| How is afterload decreased? | dialation
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| The volume coming into the heart | Preload
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| What is afterload? | The resistance to peripheral vessels.
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| What does renin cause? | The release of aldosterone
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| What does the realease of aldosterone lead to? | sodium and water retention and an increase in circulating blood therefore preload increases
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| Hyperthyroidism can contribute to what? | Heart failure
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| What is very important in heart failure pt.'s? | urine output
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| What does Cardiomyopathy show? | An enlarged heart
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| Can not breath lying down | Orthopenea
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| What is the primary clinical manifestation of left sided heart failure? | cough that leads to froathy sputum/ signs of pulmonary edema
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| How could you quickly check if a pt.'s O2 is too low? | Pulse ox
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| The main clinical manifestation of right sided heart failure is | Jugluar vein distention
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| In right sided heart failure, if pt is in bed, edema goes to where? | The most dependent position, the back
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| If a pt, gains 2-4 lbs in a day, fluid increase heart work load increase, therefore weight is important to tell about | fluid retention
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| If pt. is dehydrated, BUN and Hemct are a | false high
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| What are the three lab values that you look at for fluid volume | Hemcrit, BUN, Na
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| If a pt has fluid volume excess then BUN and Hemcrit is | low
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| What are the basic objective of medical management of HF? | Eliminate or reduce contributing factors and reduce workload on the heart by reducing afterload and preload.
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| What causes venous dialation which reduces amount of blood return to the heart and reduces preload? | Nitrates
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| If aldosterone is blocked what happens? | you get a decrease in sodium and decrease in fluid retention, which can lead to an increase in potassium.
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| What does ARB's effect? | afterload and decreased heart rate
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| When beta blockers are used with ace inhibitors reduces | mortality and morbidity by reducing the cytotoxic effects from the constant stimulation of the SNS
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| lol or OLOL | beta blockers
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| What adverse effect can Inderal cause? | Bronchioconstriction
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| What does digoxin do? | increases force of myocardial contractions, stregthens the heart
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| Normal range for dig | 0.5-2.0
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| If a pt. is hypokalemic, it makes them more likely to be dig ______. | toxic
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| How do we know if dig is effective? | what is the end result, are the symptoms getting better.
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| What are the main S&S of dig toxicity? | yellow green halos around visual images, blurred vision,nausea, and vomitting. If pt has these symptoms and dig is due, hold and call dr.
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| What electrolyte needs to be monitored when giving dig? | K+
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| What do you do if the apical heart rate is below 60 when giving dig? | Hold it, check dig level ,call dr
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| What would a T wave look like on an EKG showing HypoKalemia? | flattened
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| What would the T waves look like on an EKG for a HYPERKalemic pt.? | tall and tented.
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| What is the normal range of Na? | 135-145
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| What are foods high in K+? | dried apricots, bananas, beets, figs, orange, or tomato juice, peaches, and prunes, potatoes, raisins, spinich, squash, and watermelon.
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| What is a good source of K+ however it has major drug interactions? | Grapefruit Juice
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| When do you take a HF pt.'s Vital signs and O2 sats. | before, during, and after activity
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| How would you position a heart pt to shift fluid away from the lungs? | increase the number of pillows, HOB elevated, comfortable armchair, sitting on side of bed, support lower arms with pillow.
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| What foods are considered high in sodium? | canned or processed foods ( bacon, hot dogs, ham, sardines, canned vegetables, soups) and cheese, milk, bread.
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| What are the clinical manifestation of acute pulmonary edema? | drowning in own secretions, SOB, suffocation, hands cold and moist, nail beds cyanotic, skin ashen ( gray), excessive coughing with the pink froathy sputum
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| decreased activity tolerance may be an early indicator of | acute pulmonary edema
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| What drug is not given over 24 hours? | Nesiritide ( natrecor)
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| What does BNP do? | it binds to vascular smooth muscle and endethelial cells causing dialation of arteries and veins, lowing bp, and increasing UOP.
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