Unit A Congestive Heart Failure Study Notes
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| Classifications of CHF | show 🗑
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| a state in which the heart is no longer able to pump sufficient blood to meet all metabolic needs of the body systems. | show 🗑
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| show | low output HF
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| cardiac output remains above normal or normal; caused by increased metabolic needs or hyperkinetic conditions- septicemia, anemia, hyperthyroidism | show 🗑
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| show | systolic HF
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| show | systolic HF
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| The percentage of blood ejected from the heart during systole. | show 🗑
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| decreased ejection fraction leads to what? | show 🗑
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| Left ventricle is unable to relax adequately during diastole. Represent 20-40% of all heart failures. | show 🗑
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| Inadequate relaxtion equals what to the heart? | show 🗑
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| What is the regular ejection fraction of the heart? | show 🗑
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| show | ejection fraction less than 45%, no symptoms, only dx with echo, cardiac cath, cardiac test.
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| Class II | show 🗑
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| show | symptoms of heart failure with no exertion
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| show | symptoms at rest.
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| show | Acute MI
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| show | decrease filling of ventricles, decrease stroke volume, and increase oxygen demand.
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| thyroid disorders cause heart failure how? | show 🗑
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| hypertensive crisis | show 🗑
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| Rupture of the papillary muscles affects the heart how? | show 🗑
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| show | hole between 2 ventricles
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| what are the acute onset of CHF | show 🗑
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| Chronic onset of heart failure | show 🗑
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| Risk factors of heart failure | show 🗑
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| show | stroke volume
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| show | preload, contractility, afterload
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| the degree of fiber stretch at the end of diastole, heart is relaxed; corresponds to end diastolic volume and pressure | show 🗑
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| show | contractility
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| the pressure that the ventricles must pump against to empty the chamber effectively;systemic bld pressure | show 🗑
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| show | valves, bld volume, ventricular wall compliance, venous tone, starlings law.
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| the ability of the cardiac fibers to stretch and snap back appropriately(fibers lengthen and shorten in response to need) | show 🗑
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| show | increased SNS stimulation, positive inotropes, decreased with hypoxemia, decreased negative inotropes. increased preload = increased contractility
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| afterload depends on: | show 🗑
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| What happens when the heart has increased afterload? | show 🗑
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| _________ in aorta and carotid responds to increase CO2 and sends impulses to basomotor center in the medulla which stimulate nervous system to respond. | show 🗑
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| show | decreased stoke volume because with increased afterload, the left ventricle requires more energy to eject its contents.
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| show | disintergration of cells into membrane-bound particles that are eliminated by phagocytosis or shedding. (programmed cell death.)
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| name the neurohormones that are released in heart failure | show 🗑
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| show | hormone produced and released by the ventricles, increased to counterbalance the RAS, thus decreasing preload. Determines the degree of HF.
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| RAS? And how is RAS activated in HF clients? | show 🗑
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| What occurs in the body when RAS is activated? | show 🗑
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| which hormone from the RAS system contributes to ventricular remodeling? | show 🗑
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| What happens to the heart once it begins the ventricular remodeling process? | show 🗑
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| show | Adequate perfusion, pressure, and cardiac output.
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| show | Increased SNS= beta 1, beta 2 stimulation; increased peripheral vasoconstriction, RAS activated
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| show | is not meant to be longterm control
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| show | beta 1: Tachycardia
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| show | increase heart rate to increase cardiac output.
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| show | the heart rate will be so rapid that the filling time of the ventricles will decrease.
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| Ventricular Dilation | show 🗑
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| show | Muscle fibers begin to lengthen, increase vol. in the ventricles, stretched muscle fibers contracts more forcefully, heart requires more o2, less bld flow, and compensate more than tachycardia.
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| What eventually happens to the heart muscle during ventricular dilation. | show 🗑
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| Third and final mechanisms, initially increases the force of contraction and enlarges the heart and increase oxygen demand. | show 🗑
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| show | the heart muscles enlarges, begins to cause ventricular remodeling- increase force of contraction, afterload, O2 demand, and wall thickness.
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| What happens to the heart as the heart enlarges and the wall thickens? | show 🗑
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| show | asymptomatic.
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| show | Signs/symptoms of CHF.
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| show | 0-100
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| BNP levels of 100-400 | show 🗑
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| BNP > 400 | show 🗑
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| Usually the first to fail; the ventricle is unable to pump the sufficient blood in a forward direction. | show 🗑
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| Blood build up in left ventricle causes: | show 🗑
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| show | bld flow back in to LA, then to lungs causing SOB, and crackles.
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| Early clinical manifestations of Left HF: | show 🗑
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| show | Crackles- d/t leaking of plasma into lungs and pulmonary artery engorgement; orthopnea, PND, cheyne-stokes respirations, cardiac asthma
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| The inability to lay flat with comfortable breathing. | show 🗑
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| show | PND- Paroxysmal Nocturnal Dyspnea
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| irregular breathing pattern- apnea/tachypnea breathing | show 🗑
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| show | Cardiac asthma.
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| show | S3 and S4
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| show | anxiety, irritability, confusion, memory loss.
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| show | Nocturia-urinate at night, early sign. And oliguria- decrease urine output, in late stage.
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| show | lying down promote kidney perfusion at night.
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| During the late state of HF, oliguria occurs, why? | show 🗑
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| show | the heart is larger which moves the PMI
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| show | become diminished or weak
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| Pulsus alternans | show 🗑
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| Left sided HF is the most common cause of this type of heart failure. | show 🗑
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| How does left sided heart failure cause right sided heart failure? | show 🗑
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| Describe the events that occur during rt sided hf. | show 🗑
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| In rt ventricular heart failure, peripheral congestion in venous system causes what to the body? | show 🗑
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| Which organs are mostly affected by Rt. sided HF? | show 🗑
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| show | Weakness, JVD, anorexia, nausea and bloating, hepatomegaly, dependent edema, cyanosis of nailbeds.
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| show | sticks out. Jugular venous distention JVD
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| show | nausea, anorexia, bloating.
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| Client with RHF c/o abdominal pain, and have jaundice, due to? | show 🗑
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| show | dependent edema, pitting edema.
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| while assess the client with rt sided heart failure you noticed the nailbeds are cyanotic and capillary refills >3, in analyzing these symptoms, you realized these symptoms are due to: | show 🗑
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