Heart Failure Exam Test Questions And Answers Verified 100% Correct

Heart Failure Exam Test Questions And Answers Verified 100% Correct A forward heart failure - ANSWER- happens when afterload in increased. usually related to hypertension or aortic stenosis which does not open during systole. this causes increase afterload of the left ventricle Pulmonic stenosis and increased pulmonary resistance - ANSWER- increases afterload to the right ventricle Ejection fraction - ANSWER- falls below 40% during backward HF because there is a failure of the vent to empty due to backward/systolic failure. Right sided heart failure - ANSWER- develops from forward HF due to increase in afterload and blood is backing up into the lungs and pulmonary artery Inferior wall MI - ANSWER- is a right ventricular infarction and is systolic heart failure Diastolic HF - ANSWER- Preload is the problem Orthopnea - ANSWER- a pulmonary symptom. Dyspnea (SOB) feels worse when lying down, so will sleep on multiple pillows Happens because of the increase in venues return (preload). The heart is having a hard time pumping the blood out. Pulmonary symptoms - ANSWER- sleep apnea, hemostasis, wheezing, weight loss or gain, bloating, N&V, hepatomegaly, deceased urinary output, notarial, renal insufficiency Valve disease - ANSWER- increases afterload and causes forward heart failure Diastolic heart failure - ANSWER- a preload problem and can occur in with either ventricle Proximal nocturnal dyspnea - ANSWER- SOB that occurs several hours after falling asleep and it is eased by sitting up. This is a very late sign of severe HF An MI cause - ANSWER- Systolic HF which is also known as backward HF A Forward HF - ANSWER- caused by increased afterload from valve diseases All heart failures - ANSWER- lead to decrease output, decreased systemic blood pressure and decreased perfusion People with HF - ANSWER- always have increased levels of angiotensin 2 and that changes the treatment Hypertrophy of the left ventricle - ANSWER- one of the hearts first attempt to compensate for heart failure Blood volume before the contraction - ANSWER- preload Blood amount after contraction that heart needs to push out - ANSWER- afterload BNP (b-type natriuretic peptide) test - ANSWER- levels rise with heart disease severity. Less than 100 are normal. It is secreted predominantly in the left ventricle in response to an expansion in ventricular volume and pressure overload. It normally helps to maintain homeostasis by promoting diuresis and natriuretic (loss of sodium in the urine) BNP levels - ANSWER- below 100 not HF, above 500 probably HF, above 700 compensating HF. this is released only when the heart is stretched in HF Normal ejection fraction - ANSWER- above 55% and is the fraction of the preload right before the heart pumps it out HF triples drug cocktail - ANSWER- ace inhibitors and Aldosterone blockers to to block sodium and water retention, beta blockers to reduce BP and increase contractility, Lactone - ANSWER- diuretic drug of choice for fluid retention is an aldosterone antagonist reduces fluid retention and so preload a maintenance drug Adverse reactions to ace or arbs - ANSWER- hypotension or hyperkalemia Desired effect of ace inhibitors or arbs - ANSWER- decreases ventricular remodeling Beta blockers - ANSWER- decrease work of the heart Internal devices for HF - ANSWER- internal cardiac defibulator and cardiac resynchronization pacemaker (ICP or CRP) Agricore - ANSWER- can only be given in hospital IV. it cause vasodilation so it decreases after load and decreases fluid in the lungs. BUT can cause severe HYPOTENSION! cardiac resynchronization pacemaker - ANSWER- increase the ejection fraction, decreases remodeling, increases quality of life, decreases hospitalizations, used for pts who have an ejection fraction of less than 35% (50 is normal) Digoxin drug toxicity symptoms (normal range 0.8-2.0) - ANSWER- changes in HR, rhythm, irregular pulse, tachycardia, palpations, and arrhythmias. AND: Visual changes: halos, increase salivation, fatigue, nightmares, gi disturbances, confusion and dizziness. Doubter and Milder one - ANSWER- big guns used to increase contractility but cause increase in mortality and are only used when nothing else works. They increase O2 demand of the heart and can cause lethal arrhythmias. Dopamine and Invacare - ANSWER- positive inotropes and increase heart contractility Low potassium levels - ANSWER- get decreased from the loop diuretics and can increase digoxin risk of toxicity and cardiac dysrhythmias and this causes "paroxysmal atrial tachycardia with block" high potassium levels - ANSWER- get increased from ace inhibitors and arbs Heart Failure - ANSWER- a clinical syndrome that emerges when there is an impaired ability for the ventricles to fill with enough blood or eject enough blood to meet the body's demand Causes of HF - ANSWER- hypertension, coronary artery disease, scare tissue from a previous MI Manifestations of acute Left Sides Heart Failure - ANSWER- Exceptional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough, blood tinged sputum, cyanosis, elevation in pulmonary capillary wedge pressure Manifestations of right sided heart failure - ANSWER- fatigue, dependent edema, distention of the jugular veins, liver engorgement, ascites, anorexia and complaints of GI distress, cyanosis, elevation in peripheral venous pressure, and nutria Backward effects of Left sided HF - ANSWER- decreased emptying of the left ventricle, increased volume and pressure in left vent, increased pressure volume in left atrium, increased volume on pulmonary veins, increased volume in pulmonary capillary bed transudation of fluid from capillaries to alveoli, rapid filling of alveolar spaces = Pulmonary Edema Forward effects of left sided HF - ANSWER- decreased cardiac output, decreased perfusion in tissues of body, decreased blood flow to kidneys and glands, increased