LEHNE’S PHARMACOTHERAPEUTICS
FOR ADVANCED PRACTICE NURSES
AND PHYSICIAN ASSISTANTS EXAM
AND ITS ANSWERS
Two major forms of heart failure
1) heart failure with left ventricular systolic dysfunction
2) diastolic heart failure, also known as heart failure with
preserved LV ejection fraction
Progressive, often fatal disorder characterized by
ventricular dysfunction, reduced cardiac output,
insufficient tissue perfusion, and signs of fluid
retention
Heart failure
Drugs recommended for treatment of heart failure
diuretics, inhibitors of RAAS, beta blockers, and digoxin
Heart failure is a syndrome in which
the heart is unable to pump sufficient blood to meet the
metabolic needs of tissues
Heart failure is characterized by
signs of inadequate tissue perfusion and/or signs of
volume overload
Signs of inadequate tissue perfusion
fatigue, shortness of breath, exercise intolerance
signs of volume overload
venous distention, peripheral and pulmonary edema
Major underlying causes of HF
chronic hypertension and myocardial infarction
, Other causes of HF
valvular heart disease, coronary artery disease, congenital
heart disease, dysrhythmias, and aging of the myocardium
What happens when the heart undergoes remodeling
ventricles dilate, hypertrophy, and become more spherical
The alterations that occur during remodeling increase
______ and reduce ______
wall stress, LV ejection fraction
Remodeling occurs in response to
Cardiac injury, brought on by infarction and other causes
Water retention in HF results from two mechanisms
reduced cardiac output and activation of the RAAS
Reduced cardiac output leads to what compensatory
responses
1) cardiac dilation
2) activation of the SNS
3) activation of the RAAS
4) retention of water and expansion of blood volume
The New York Heart Association classifies HF based
on
the functional limitations it causes
The American College of Cardiology and the American
Heart Association classifies HF based on
the observation that HF is a progressive disease that
moves through stages of increasing severity
Class 1 of the NYHA scheme
no limitation of ordinary physical activity
Class 2 of the NYHA scheme
slight limitation of physical activity: normal activity
produces fatigue, dyspnea, palpitations, or angina
Class 3 of the NYHA scheme
FOR ADVANCED PRACTICE NURSES
AND PHYSICIAN ASSISTANTS EXAM
AND ITS ANSWERS
Two major forms of heart failure
1) heart failure with left ventricular systolic dysfunction
2) diastolic heart failure, also known as heart failure with
preserved LV ejection fraction
Progressive, often fatal disorder characterized by
ventricular dysfunction, reduced cardiac output,
insufficient tissue perfusion, and signs of fluid
retention
Heart failure
Drugs recommended for treatment of heart failure
diuretics, inhibitors of RAAS, beta blockers, and digoxin
Heart failure is a syndrome in which
the heart is unable to pump sufficient blood to meet the
metabolic needs of tissues
Heart failure is characterized by
signs of inadequate tissue perfusion and/or signs of
volume overload
Signs of inadequate tissue perfusion
fatigue, shortness of breath, exercise intolerance
signs of volume overload
venous distention, peripheral and pulmonary edema
Major underlying causes of HF
chronic hypertension and myocardial infarction
, Other causes of HF
valvular heart disease, coronary artery disease, congenital
heart disease, dysrhythmias, and aging of the myocardium
What happens when the heart undergoes remodeling
ventricles dilate, hypertrophy, and become more spherical
The alterations that occur during remodeling increase
______ and reduce ______
wall stress, LV ejection fraction
Remodeling occurs in response to
Cardiac injury, brought on by infarction and other causes
Water retention in HF results from two mechanisms
reduced cardiac output and activation of the RAAS
Reduced cardiac output leads to what compensatory
responses
1) cardiac dilation
2) activation of the SNS
3) activation of the RAAS
4) retention of water and expansion of blood volume
The New York Heart Association classifies HF based
on
the functional limitations it causes
The American College of Cardiology and the American
Heart Association classifies HF based on
the observation that HF is a progressive disease that
moves through stages of increasing severity
Class 1 of the NYHA scheme
no limitation of ordinary physical activity
Class 2 of the NYHA scheme
slight limitation of physical activity: normal activity
produces fatigue, dyspnea, palpitations, or angina
Class 3 of the NYHA scheme
