NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
NUR2502 Exam 3 Focused Review (Chapters 34, 35, 36, 38, 39, 40)
● Heart failure
o causes
▪ A common chronic health problem with acute episodes
often causing hospitalization. Acute coronary disease and
other structural or functional problems of the heart can
lead to acute HF.
▪ Caused by systemic HTN in most cases
▪ Common causes and Risk factors for HF:
● HTN, coronary artery disease, cardiomyopathy,
substance abuse, valvular disease, congenital defects,
cardiac infections and inflammations, dysrhythmias,
DM, smoking/tobacco use, family history, obesity,
severe lung disease, sleep apnea, hyperkinetic
conditions (hyperthyroidism)
o left vs right
▪ Left sided heart (ventricular) failure includes HTN, coronary
artery disease, and valvular disease. Decreased tissue
perfusion from poor cardiac output and pulmonary
congestion from increased pressure in the pulmonary vessels
indicate left ventricular failure
● Formerly referred to as congestive HF; not all cases of
LVF involve fluid accumulation
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
,NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
● May be acute or chronic and mild to severe.
● Two types:
o Systolic: heart cannot contract forcefully enough
during systole to eject adequate amounts of
blood into the circulation
o Diastolic: left ventricle cannot relax adequately
during diastole- ventricle can not fill with
sufficient blood to ensure an adequate cardiac
output
▪ Right sided heart (ventricular) failure may be caused by left
ventricular failure, right ventricular MI, or pulmonary HTN
(cor pulmonale). The right ventricle cannot empty
completely. Increased volume and pressure develop in the
venous system and peripheral edema results.
o diagnosis
▪ Labs:
● Electrolytes - may occur from complications or diuretics
● Hgb and HCT - identify HF resulting from anemia
● BNP - used when dyspnea to r/o HF
● U/A - proteinuria/high specific gravity
● ABGs- respiratory acidosis
▪ B-type natriuretic peptide (BNP)
● is used for diagnosing HF (in particular, diastolic HF),
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
,NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
in patients with acute dyspnea
▪ Microalbuminuria
● An early indicator of decreased compliance of the
heart and occurs before the BNP rises
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
, NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
● “early warning detector” that lets HCP know that the
heart is experiencing early signs of decreased
compliance long before symptoms occur
▪ CXR
● Helpful in diagnosing left ventricular failure
because the heart is enlarged, representing
hypertrophy or dilation
▪ Echocardiography
● Best tool in diagnosing HF- ejection fraction between 50-70%
● Cardiac valvular changes, pericardial effusion,
chamber enlargement, and ventricular hypertrophy
can be diagnosed with this noninvasive technique
● Can also be used to determine ejection fraction
▪ Hemodynamic Monitoring
● PA catheter allows for assessment of cardiac function and fluid
volume
● PAP (positive airway pressure) /PAWP (pulmonary
artery wedge pressure) elevated with L sided HF
because volumes and pressures are increased in the
left ventricle
●
o
s/s ▪ Left HF:
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
39, 40) Fall 2020,100% CORRECT
NUR2502 Exam 3 Focused Review (Chapters 34, 35, 36, 38, 39, 40)
● Heart failure
o causes
▪ A common chronic health problem with acute episodes
often causing hospitalization. Acute coronary disease and
other structural or functional problems of the heart can
lead to acute HF.
▪ Caused by systemic HTN in most cases
▪ Common causes and Risk factors for HF:
● HTN, coronary artery disease, cardiomyopathy,
substance abuse, valvular disease, congenital defects,
cardiac infections and inflammations, dysrhythmias,
DM, smoking/tobacco use, family history, obesity,
severe lung disease, sleep apnea, hyperkinetic
conditions (hyperthyroidism)
o left vs right
▪ Left sided heart (ventricular) failure includes HTN, coronary
artery disease, and valvular disease. Decreased tissue
perfusion from poor cardiac output and pulmonary
congestion from increased pressure in the pulmonary vessels
indicate left ventricular failure
● Formerly referred to as congestive HF; not all cases of
LVF involve fluid accumulation
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
,NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
● May be acute or chronic and mild to severe.
● Two types:
o Systolic: heart cannot contract forcefully enough
during systole to eject adequate amounts of
blood into the circulation
o Diastolic: left ventricle cannot relax adequately
during diastole- ventricle can not fill with
sufficient blood to ensure an adequate cardiac
output
▪ Right sided heart (ventricular) failure may be caused by left
ventricular failure, right ventricular MI, or pulmonary HTN
(cor pulmonale). The right ventricle cannot empty
completely. Increased volume and pressure develop in the
venous system and peripheral edema results.
o diagnosis
▪ Labs:
● Electrolytes - may occur from complications or diuretics
● Hgb and HCT - identify HF resulting from anemia
● BNP - used when dyspnea to r/o HF
● U/A - proteinuria/high specific gravity
● ABGs- respiratory acidosis
▪ B-type natriuretic peptide (BNP)
● is used for diagnosing HF (in particular, diastolic HF),
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
,NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
in patients with acute dyspnea
▪ Microalbuminuria
● An early indicator of decreased compliance of the
heart and occurs before the BNP rises
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
, NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
● “early warning detector” that lets HCP know that the
heart is experiencing early signs of decreased
compliance long before symptoms occur
▪ CXR
● Helpful in diagnosing left ventricular failure
because the heart is enlarged, representing
hypertrophy or dilation
▪ Echocardiography
● Best tool in diagnosing HF- ejection fraction between 50-70%
● Cardiac valvular changes, pericardial effusion,
chamber enlargement, and ventricular hypertrophy
can be diagnosed with this noninvasive technique
● Can also be used to determine ejection fraction
▪ Hemodynamic Monitoring
● PA catheter allows for assessment of cardiac function and fluid
volume
● PAP (positive airway pressure) /PAWP (pulmonary
artery wedge pressure) elevated with L sided HF
because volumes and pressures are increased in the
left ventricle
●
o
s/s ▪ Left HF:
NUR2502/MDC Exam 3 Focused Review (Chapters 34, 35, 36, 38,
39, 40) Fall 2020,100% CORRECT
