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Stack #38898
RRC Maintenance - Heart failure
| question | answer |
|---|---|
| ventricular dysfunction | can no longer pump effectively due to decreased ejection fraction, therefore heart needs to pump faster to compensate |
| left sided HF | LV dysfunction which cause backup into LA and into pulmonary veins...this increases pulmonary pressure causing fluid to shift from circulatory system into the alveolar space in lungs causing pulmonary edema |
| right sided HF | backward flow into RA and venous circulation ... resulting in peripheral edema, hepatomegaly, splenomegaly, vascular congestion of GI tract, jugular vein distention |
| fatigue | decreased perfusion of O2 to tissues (brain), decreased cardiac output, impaired circulation, decrease oxygenation of tissues and anemia |
| dyspnea | cause by increased pulmonary pressures secondary to interstitial and alveolar edema; air hunger will cause increased HR/RR |
| tachycardia | compensation of failing ventricle to increase HR; also due to decreased CO which stimulates SNS which also increases HR |
| edema | L -> pulmonary; R -> peripheral edema |
| nocturia | less resistance to flow (does not have to flow against gravity), therefore better renal perfusion which will result in increase urine formation, also fluid movement from interstitial space into circulation is enhanced |
| behavioral changes | due to lack to O2 to brain due to decreasing CO, may also be r/t poor gas exchange (pulmonary edema) or worsening renal failure |
| chest pain/discomfort | increased work of heart as well as lack of O2 and also r/t decrease coronary perfusion from decreased CO and increased myocardial work |
| weight changes | increases in weight indicate progression of heart failure or ineffectiveness of medication to get rid of excess fluid being retained |
| s+sx of left sided HF | dyspnea, cough, tachypnea, pleural effusion, cyanosis, nocturia, change in LOC, S3 sounds, arrthymias, poor O2 exchange, crackles, LV heaves, cheyne-stokes respirations |
| s+sx of right sided HF | distended jugular vein, acsites, peripheral edema progressing to anasarca, weight gain, abdominal distention, nausea/vomiting, changes in LOC, (R) sided pleural effusion, heart murmurs, tachycardia, dependent edema, hepatomegaly |
| stage 1 | asymptomatic (diagnosed if hypertensive) |
| stage 2 | cough, dyspnea, increase pulse, fatigue and/or angina with mild exertion |
| stage 3 | SOB, increased pulse, chest pain with ADLs |
| stage 4 | symptoms with both activity and rest |
| definitive diagnostic test | echocardiogram - shows pictures of valves and valvular dysfunction |
| risk factors for heart failure | hypertension, diabetes, cigarette smoking, obesity, renal disorders, congenital heart anomalies, anemia, polycythemia, infection, metabolic disorders |
| Why is someone with HF weighed daily? | to monitor for fluid retention and weight reduction |
| how is preload decreased in HF? | diuretics, increase HOB |
| What does nitroglycerin do in HF? | reduced circulating volume by decreasing preload, increases coronary artery circulation by dilating coronary arteries...reduces preload, slightly reduces afterload and increases myocardial O2 supply |
| What are the benefits of O2 therapy in HF? | increases percentage of O2 inspired, relieves dyspnea and fatigue |
| Why is digoxin used in HF? | increases contractility |
| Positive inotropic action | increases force of ventricular contraction which increases CO |
| chronotropic action | decreases conduction speed within myocardium and decreases HR |
| Why does hypokalemia increase the risk for dig toxicity? | they bind to same sites, therefore if K+ is lost, then there are more site for digoxin to bind to increasing the risk for dig toxicity |
| s+sx of digoxin toxicity | severely bradycardic, bounding HR, decreased LOC |
| what is the purpose of administering a vasodilator to someone who is experiencing HF? | to decrease afterload by promotion of vasodilation |
| Why are diuretic used in HF? | to decrease preload by decreasing excess circulating volume |
Created by:
bella83
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