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29 Cards in this Set
- Front
- Back
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Heart Failure - Definition
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Cluster of signs/symptoms that arise when the ventricles (left, right, or both) lose ability to pump enough blood to meet the body’s circulatory needs
Systolic dysfunction (contraction dysfunction) |
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Heart Failure - Symptoms
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decreased exercise tolerance
poor peripheral tissue perfusion Diastolic dysfunction (filling dysfunction) pulmonary congestion pulmonary edema |
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Heart Failure - how it works
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Body Compenates by:
Releases epinephrine and norepinephrine RAAS stimulates renal distal tubule to retain sodium and water Increases production of vasopressin Kidneys increase sodium reabsorption, increasing blood volume, causing increased pressure within capillaries, resulting in edema formation Heart muscle hypertrophy (increase muscle size) |
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Heart Failure - Treatment
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Correct underlying disease (e.g., coronary artery disease, hypertension, dyslipidemia, thyroid disease)
Bed rest when necessary Sodium-restricted diet Control symptoms with combination of drugs |
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Heart Failure - Goals
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Reduce signs/symptoms associated with fluid overload
Increase exercise tolerance Prolong life |
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Heart Failure - Drug Therapy
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Vasodilators – reduce strain on left ventricle by reducing systemic vascular resistance (afterload)
Inotropic agents – boost cardiac output by stimulating the heart to increase force of contractions Diuretics – enhance sodium and water excretion, reducing preload |
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Heart Failure - Nursing Assessment
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Obtain history of heart disease, related cardiovascular diseases
Six cardinal signs of heart disease Presence of altered cardiac function |
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Heart Failure - Diagnostic Tests
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Echocardiogram, ECG, nuclear imaging studies, chest x-ray, laboratory tests
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Heart Failure - Related diseases and causes
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Related diseases
hypertension, hyperlipidemia, diabetes mellitus, lung disease. Causes of systolic dysfunction coronary artery disease MI - if muscle damage congestive heart failure congenital heart disease cardiomyopathy |
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Heart Failure - Six cardinal signs of heart disease
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dyspnea, chest pain, fatigue, edema, syncope, palpitations.
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Heart Failure - Digoxin - actions
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Actions
Positive inotropy Negative chronotropy |
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Digoxin - Uses
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Treat moderate to severe systolic failure not responding to diuretics and ACE inhibitors
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Dgioxin - Side effects
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Digoxin toxicity
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Digoxin - notes
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Always take the apical pulse for 1 full minute before administration; do not administer when heart rate is less than 60.
Maintenance dosing given daily. Digoxin toxicity related to long half-life. Digoxin immune Fab (ovine) (Digibind) is the antidote. |
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Inamrione & milrione - actions
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Actions
Increase the force and velocity of myocardial contractions |
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Inamrione & milrione - uses
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Short-term management of systolic dysfunction heart failure in patients not responding adequately to digoxin, diuretics, or vasodilator therapy
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Ace Inhibitors - actions
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Actions
Reduce afterload by blocking angiotensin II-mediated peripheral vasoconstriction; reduce preload |
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Ace inhibitors - Uses
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Treat mild to moderate systolic dysfunction heart failure
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Beta Blockers - Actions
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Actions
Inhibit cardiac response to sympathetic nerve stimulation; inhibit renin release |
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Beta blockers - uses
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Uses
In combination with ACE inhibitors to treat heart failure |
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Natriuretic Peptides - drugs
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Drug: nesiritide (Natrecor)
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Natriuretic Peptides -Actions
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Actions
Reduce preload and afterload pressures, increasing diuresis and sodium excretion Suppress RAAS Reduce secretion of norepinephrine |
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Natriuretic Peptides -uses
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Uses
Treat severe heart failure |
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Natriuretic Peptides
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Natriuretic peptide is a hormone normally secreted by the cardiac ventricles in response to fluid and pressure overload.
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Ace inhibitors - Therapuetic outcome
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Improved cardiac output with improved tissue perfusion; improved tolerance to exercise.
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Heart Failure Drug therapay - therapuetic outcomes
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Therapeutic outcomes: reduce systemic vascular resistance (afterload); reduce preload.
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Heart failure - Facts
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Affects an estimated 5 million Americans.
The number of other conditions that complicate its treatment increases as people live longer. |
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Diastolic dysfunction
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heart fills during diastolic contraction but does not allow release of proper amount of blood.
If heart fills up too much blood backs up to the lungs causes pulmonary edema wet cough pulmonary congestion |
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stimulating factors to the sympathetic nervous system - all do the same thing
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cathacolemines
epinephrine norepineprine sympathetic stimulate sympathetic neuro transmitters |
