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33 Cards in this Set
- Front
- Back
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most common heart failure |
Left sided |
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heart failure what is it |
impaired heart function, unable to maintain a CO sufficient to meet metobolic needs |
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types of heart failure |
R ventricular, L ventricular, biventricular systolic, diastolic acute, chronic, "CHF" |
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systolic heart failure is |
failure w/contractility |
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diastolic heart failure is |
failure of resting to allow for proper filling |
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what type of heart failure can not be fixed |
chronic (ex:MI) |
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causes for heart failure |
increased workload-HTN, increased HR, valvular disease MI, CAD, cardiomyopathy, bradycardia, congential defects, volume overload |
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most common cause of heart failure |
CAD (leads to MI) , HTN |
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compensatory mechanisms w/heart failure |
worsens HF |
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BNP |
released in response to fluid overload & increased stretch |
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endothelin |
released with stretch, potent vasoconstrictor |
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ADH |
released from brain, vasoconstrictor-> fluid retention |
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s&sx of Left sided heart failure |
*think lungs* crackles, ronchi, decreased b.s., wheezing, dyspnea, PND increased HR, S3&4, restless, anxious, fatigue |
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s&sx Right sided heart failure |
JVD, organ swelling, peripheral edema, ascites, wt gain, tachy, GI |
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dx of heart failure |
severity of s&sx- ADL's, palpitations, chest discomfort, ftigue CXR, ECG, echo, labs (BNP, kidney func) |
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best dx test for HF |
echocardiogram |
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BNP |
ventricles secrete BNP w/incraeased ventricular pressure and myocardial stretch that occurs w/HF |
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BNp good or bad for HF |
Good! draws fluid to periphs & opens arteries promotes vasodilation |
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O2 admin w/HF (what does it do) |
airway support, bronchofilators |
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what to use to decrease anxiety |
morphine |
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what to use to decrease preload |
meds- diuretics, ntg, morphine, nesiritide high fowlers fluid restrict. ultrafiltration |
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how to decrease afterload |
vasodilator ntg, nesiritide |
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improve contractility |
positive inotropes- dig & dobutamine |
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control HR |
dig & diltiazem |
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what is ultrafiltration |
similar to dialysis removal of excess fluid ONLY pulls saline pt has to be on heparin w/this especially iseful when resistant to diuretuc tx |
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healthy people 2020 goal |
reduce hospitalizations of HF pt's by 50% |
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long term therapy to reduce preload |
limit Na+ intake, fluid restrict., nitrates, diuretics |
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long term to reduce afterload |
ACE inhibitors- "PRIL"- dilation, blocks contriction by blocking angiotensin II ARB's- "SARTAN"- block ang II receptors |
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how to increase contractility |
cardiac glycoside- digoxin |
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how to control HR |
cardiac glycoside- digoxin Ca+ channel blocker- diltiazem- decrease HR, vasodilates beta-blockers- carvedilol, metoprolol- decrease HR, contractility, makes heart more efficient (low dose) |
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carvedilol |
alpha and beta effects alpha- vasodilation, lowers HR, contractility, afterload, makes more efficient CO |
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what is resynchronization therapy used for |
low ejection fraction |
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other options for HF mgm't |
heart transplant assist device- LVAD, IABP internal defibulator- prevent sudden cardiac death stem cell |
