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NURS 319: Heart Fail
Chapter 17: Heart Failure
| Question | Answer |
|---|---|
| normal ejection fraction | 55-75% |
| heart failure ejection fraction | less than 40% |
| cardiac output | amount of blood pumped by LV per minute |
| preload | amount heart is filled with per beat |
| afterload | resistance that heart pumps against |
| stroke volume | amount of blood pumped from LV in one minute |
| heart rate | amount of heartbeats (usually measured per minute) |
| cardiac output equation | CO = SV x HR |
| average cardiac output is | 4900 mL/min at rest |
| force of the heart's contraction | heart contractility |
| increased preload does what to cardiac output/ stroke volume | increases (to a point) |
| increased afterload does what to cardiac output/ contractility | reduces it |
| pushes fluid out of the capillary pores and into the interstitial and intracellular spaces | hydrostatic pressure |
| pulls fluid from the interstitial and intracellular spaces back into the capillary | oncotic pressure |
| regulatory mechanism that responds to changes in BP and blood volume | RAAS |
| process of RAAS | BP low, kidneys notice- secrete renin. renin flows in bloodstream, flagged by liver- liver releases angiotensinogen. lungs receive it & ace enzyme converts angiotensin 1 to angiotensin 2. angiotensin 2 increases BP, HR, secrete ADH and aldosterone |
| describe the role of ANP | protein from atria; increases urine output, blocks renin and aldosterone, decreases from vasoconstriction |
| describe the role of BNP | released from ventricles |
| endothelin | stimulates vasoconstriction |
| TNF-alpha | hypertrophy, fibrotic changes, myocardial cell apoptosis |
| Nitric oxide | vasodilator, regulates blood flow to tissues |
| ADH | decreases urine output, increases blood volume |
| ANS | increase HR and contractility; vasoconstriction |
| SNS/PNS | decrease HR and contractility |
| what are some various causes of heart failure? | hypertension, CAD, angina, MI, valvular disease, pulmonary problems, cardiomyopathies, dysrhythmias, cardiac infections |
| risk factors for heart failure | HTN, CAD, MI, metabolic syndrome/ obesity, age ethnicity, diabetes, family history, sleep apnea, congenital heart defects, smoking, sedentary lifestyles, medications, anabolic steroids, viral myocarditis, alcohol abuse, kidney conditions |
| acute heart failure | rapid onset |
| chronic heart failure | ventricles gradually weaken (more common) |
| systolic (HFrEF) | pump problem; pump backs up and fills heart EF: <40% |
| diastolic (HFpEF) | heart has difficulty filling; EF: >50%, looks normal just less volume |
| high output heart failure | heart cannot meet high circulatory needs |
| low output heart failure | heart is not able to fill |
| process of backwards effects of LV HF | blood backs up in the heart due to weak pump hydrostatic pressure backs up into pulmonary circulation (pulmonary edema) crackles, orthopnea, paroxysmal nocturnal dyspnea |
| 3 things that occur during the forward effects of LV HF | blood cannot move out of the heart effectively to perfuse the body decreased perfusion active SNS, RAAS, ADH to compensate |
| process of right-sided HF | right ventricle enlarges and gets weaker |
| left-sided HF backward effects | dyspnea, orthopnea, PND, cough, frothy sputum, crackles heard on auscultation |
| right-sided HF backward effects | JVD, hepatomegaly, splenomegaly, abdominal distention and ascites, nausea and anorexia, peripheral edema, weight gain |
| left-sided HF forward effects | confusion, memory loss, anxiety, decrease blood flow to GI tract, muscle weakness, poor urine output |
| right-sided HF forward effects | hypoxia, cyanosis, fatigue, weakness |
| what weight gains would be concerning for a HF patient? | 2 lbs in 24 hours or 5 lbs in one week |
| protein released when there is a stretching of the ventricles | BNP |
| what causes BNP to be released | retained fluid in the body |
| diagnostic tools to diagnose heart failure | blood work, chest x-ray, ECG/EKG, echocardiogram, cardiac catheterization, angiography |
Created by:
lcorlew1
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