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Cardio III Exam II
N130 OLOL Cardio III Exam II
| Question | Answer |
|---|---|
| A clinical syndrome characterized by s and s of fluid overload or of inadequate tissue perfusion? | Heart Failure |
| What is usually an acute presentation of HF? | CHF |
| What is the most common reason for hospitalization of people older than 65? | Heart failure |
| What is the 2nd most common reason for a visit to a physicians office? | Heart failure |
| What is wrong in diastolic heart failure? | something wrong with the ventricular filling |
| What is wrong in systolic heart failure? | something wrong with the ventricular contraction/pumping |
| 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. |
| Ejection fraction is normal in | diastolic HF |
| Ejection fraction is less than 40% in | systolic HF |
| Ejection Fraction | When the heart contracts it doesn't completly empty of blood, usually 60-70 % |
| The harder the heart works, the more ________ it needs | oxygen |
| co= | HR x SV |
| Preload is decreased by | diuretics |
| How is afterload decreased? | dialation |
| The volume coming into the heart | Preload |
| What is afterload? | The resistance to peripheral vessels. |
| What does renin cause? | The release of aldosterone |
| What does the realease of aldosterone lead to? | sodium and water retention and an increase in circulating blood therefore preload increases |
| Hyperthyroidism can contribute to what? | Heart failure |
| What is very important in heart failure pt.'s? | urine output |
| What does Cardiomyopathy show? | An enlarged heart |
| Can not breath lying down | Orthopenea |
| What is the primary clinical manifestation of left sided heart failure? | cough that leads to froathy sputum/ signs of pulmonary edema |
| How could you quickly check if a pt.'s O2 is too low? | Pulse ox |
| The main clinical manifestation of right sided heart failure is | Jugluar vein distention |
| In right sided heart failure, if pt is in bed, edema goes to where? | The most dependent position, the back |
| 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 |
| If pt. is dehydrated, BUN and Hemct are a | false high |
| What are the three lab values that you look at for fluid volume | Hemcrit, BUN, Na |
| If a pt has fluid volume excess then BUN and Hemcrit is | low |
| 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. |
| What causes venous dialation which reduces amount of blood return to the heart and reduces preload? | Nitrates |
| 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. |
| What does ARB's effect? | afterload and decreased heart rate |
| When beta blockers are used with ace inhibitors reduces | mortality and morbidity by reducing the cytotoxic effects from the constant stimulation of the SNS |
| lol or OLOL | beta blockers |
| What adverse effect can Inderal cause? | Bronchioconstriction |
| What does digoxin do? | increases force of myocardial contractions, stregthens the heart |
| Normal range for dig | 0.5-2.0 |
| If a pt. is hypokalemic, it makes them more likely to be dig ______. | toxic |
| How do we know if dig is effective? | what is the end result, are the symptoms getting better. |
| 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. |
| What electrolyte needs to be monitored when giving dig? | K+ |
| What do you do if the apical heart rate is below 60 when giving dig? | Hold it, check dig level ,call dr |
| What would a T wave look like on an EKG showing HypoKalemia? | flattened |
| What would the T waves look like on an EKG for a HYPERKalemic pt.? | tall and tented. |
| What is the normal range of Na? | 135-145 |
| What are foods high in K+? | dried apricots, bananas, beets, figs, orange, or tomato juice, peaches, and prunes, potatoes, raisins, spinich, squash, and watermelon. |
| What is a good source of K+ however it has major drug interactions? | Grapefruit Juice |
| When do you take a HF pt.'s Vital signs and O2 sats. | before, during, and after activity |
| 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. |
| What foods are considered high in sodium? | canned or processed foods ( bacon, hot dogs, ham, sardines, canned vegetables, soups) and cheese, milk, bread. |
| 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 |
| decreased activity tolerance may be an early indicator of | acute pulmonary edema |
| What drug is not given over 24 hours? | Nesiritide ( natrecor) |
| 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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