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75 Cards in this Set
- Front
- Back
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Heart Failure Definition |
heart unable to maintain adequate circulation |
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Pulmonary edema definition |
accumulation of fluid in the alveoli and interstitial spaces of the lung |
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class I heart F |
no symptoms with activity |
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class II heart F |
symptoms with ordinary exertion |
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class III heart F |
symptoms with minimal exertion |
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class IV heart F |
symptoms at rest |
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low-output heart F can occur |
initially on left or right side of heart |
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left-sided heart F |
inadequate CO |
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right-sided heart F |
inadequate right ventricle output and systemic venous congestion |
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forms of left-sided heart F |
systolic F diastolic F |
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left-sided systolic F |
ejection fraction < 40% pulmonary congestion peripheral congestion |
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left-sided diastolic F |
inadequate relaxation or 'stiffening' prevents ventricular filling |
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high-output failure |
CO normal unable to meet tissue demands |
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symptoms of heart F |
fatigue SOB |
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causes of high-output failure |
severe anemia hyperthyroidism arteriovenous fistula beriberi Paget's disease |
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Beriberi |
deficiency of thiamine (Vit B1) |
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Paget's disease |
abnormal breakdown and regrowth of bones, which develop an excessive amount of blood vessels |
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arteriovenous fistula |
an abnormal connection between an artery and a vein |
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risk factors for left-sided heart failure |
hypertension coronary artery disease angina MI mitral and aortic valvular disease |
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risk factors for right-sided failure |
left-sided failure right ventricular MI COPD pulmonary fibrosis |
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risk factors for high-output heart failure |
increased metabolic needs septicemia anemia hyperthyroidism |
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risk factors for cardiomyopathy |
coronary heart disease infection of inflammation of heart muscle various cancer treatments prolonged alcohol use heredity |
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left-sided heart F s/s |
dyspnea, orthopnea,nocturnal dyspnea fatigue displaced apical pulse (hypertrophy) S3 heart sound (gallop) pulmonary congestion(dyspnea, cough, bibasilar crackles) frothy sputum(can be blood tinged) ALOC manifestations of organ F (i.e. oliguria) |
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right-sided heart F s/s |
JVD ascending dependent edema abdominal distension, ascites fatigue,weakness polyuria at rest (nocturnal) hepatomegaly and tenderness weight gain |
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four types of cardiomyopathy |
dilated*** hypertrophic arrhythmogenic right ventricular restrictive |
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cardiomyopathy s/s |
fatigue/weakness heart F >left-sided with dilated type >right-sided with restrictive type S3 gallop cardiomegaly (more severe w/dilated type) angina (hypertrophic type) |
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dilated cardiomyopathy |
starts in the left ventricle. The heart muscle begins to stretch and become thinner. This causes the inside of the chamber to enlarge. The problem often spreads to the right ventricle and then to the atria as the disease gets worse. |
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hypertrophic cardiomyopathy |
myocardium becomes abnormally thick |
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arrhythmogenic cardiomyopathy |
breakdown on the myocardium surrounding the right ventricle |
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elevated hBNP occurs in |
heart failure |
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hBNP < 100 pg/dL |
no heart failure |
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hBNP between 100 - 300 pg/dL |
suggests heart failure |
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hBNP > 300 pg/dL indicates |
mild heart F |
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hBNP >600 pg/dL indicates |
moderate heart failure |
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hBNP > 900 pg/dL indicates |
severe heart failure |
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drop in SvO2 indicates |
worsening cardiac functioning |
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heart failure generally results in |
increased CVP increased PAWP increased PAP decreased CO |
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diagnostic testing heart failure |
hemodynamic monitoring us transesophageal echocardiography TEE chest x-ray ECG cardiac enzymes, electrolytes, ABGs |
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digoxin toxicity s/s |
N/V, loss of apetite fatigue muscle weakness confusion visual disturbances bradycardia arrhythmias |
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treatment of life-threatening digixon toxicity |
administer digoxin immune Fab (Digibind) |
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meds to correct arhythmias from digoxin toxicity |
lidocaine procainamide quinidine propranolol phenytoin |
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meds used to treat heart failure |
diuretics afterload-reducing agents inotropic agents beta-adrenergic blockers vasodilators hBNPs anticoagulants |
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diuretics |
furosemide bumetanide hydrocholorothiazide spironolactone |
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loop diuretics |
furosemide (Lasix) bumetanide (Bumex) |
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thiazide diuretics |
hydrochlorothiazide (Hydrodiuril) |
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K-sparing diuretics |
spironolactone (Aldactone) |
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administer furosemide IV no faster than |
20 mg/min |
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loop and thiazide diuretics may cause |
hypokalemia, K supplements may be nec |
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teach P taking loop and thiazide diuretics |
ingest foods and drinks high in K |
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after-load reducing agents action |
help the heart pump more easily by altering the resistance to contraction |
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after-load reducing meds |
ACE inhibitors angiotensin receptor II blockers Ca channel blockers phosphodiesterase-3 inhibitors |
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after-load agents are |
contraindicated for P w/ renal deficiency |
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ACE inhibitors |
enalapril (Vasotec) captopril (Capoten) |
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angiotensin receptor II blockers |
larsartan (Cozaar) |
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calcium channel blockers |
diltiazem (Cardizem) nifedipine (Procardia) |
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phosphodiesterase-3 inhibitors |
milrinone (Primacor) |
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monitor P taking these cardiac meds for hyptension for 2 hours following the first dose |
ACE inhibitors |
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ACE inhibitors can cause |
angioedema decreased sense of taste rash |
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angioedema |
swelling of the tongue and throat |
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monitor P taking ACE inhibitors for |
increased levels of K |
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inform P that ACE inhibitors |
can cause dry mouth BP needs to be monitr for 2 hrs post initial dose notify MD: if rash, decreased sense of taste or swelling of face or extremeties occurs |
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inopropic agents |
digoxin (Lanoxin) dopamine/dobutamine (Dobutrex) milrinone (Primacor) |
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digoxin |
take apical pulse for 1 min hold med if pulse is less than 60 bpm notify provider |
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monitor for N/V |
digoxin |
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dopamine, dobutamine, milrinone |
administered IV closely monitor: EKG, BP and urine output |
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P instructions for self medication of digoxin |
count pulse for 60 seconds take med at same time/day do not take at same time as antacids(2 hrs apart) report s/s toxicity have med levels and K levels taken regularly |
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common beta-adrenergic blockers (beta-blockers) |
carvedilol (Coreg) metoprolol (Lopressor) |
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beta-blockers my be used for P who has |
sustained increased levels of sympathetic stimulation and catecholamines > includes chronic heart F |
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nursing considerations for P taking beta-blockers |
monitor BP, pulse, activity tolerance, orthopnea check orthostatic blood pressure readings |
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client ed for P taking beta-blockers |
weigh daily regularly check BP follow MD instructions on increasing dosage |
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vasodilators |
nitroglycerine (Nitrostat) isosorbide mononitrate (Imdur) |
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vasodilators effect |
prevent coronary artery vasospasm and reduce preload and afterload, decreasing myocardial oxygen demand |
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vasodilators used to treat |
angina contol BP |
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vasodilators can cause |
orthostatic hypotension |
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common side effects of nitroglycerin (Nitrostat) |
HA encourage P to sit and lie down slowly |
