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NURS 319: Heart Fail

Chapter 17: Heart Failure

QuestionAnswer
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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