Cardiac Output and Heart Failure Overview
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Questions and Answers

Which of the following valves is NOT associated with unidirectional blood flow in the heart?

  • Tricuspid valve
  • Coronary valve (correct)
  • Mitral valve
  • Pulmonary valve

    • Aortic stenosis is a type of valve regurgitation.

    False

    Name two common clinical manifestations of valve disorders.

    Palpitations, weakness

    The ___________ test is commonly used to diagnose valvular heart disease.

    <p>echocardiogram</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Stenosis = Narrowing of heart valves that impedes blood flow Regurgitation = Backward flow of blood due to valve incompetence Anticoagulation therapy = Medication to prevent blood clots Valve replacement = Surgical procedure to replace a damaged valve</p> Signup and view all the answers

    What is the normal range for cardiac output (CO)?

    <p>4 to 8 L/min</p> Signup and view all the answers

    Stroke volume (SV) is the amount of blood pumped by the heart in one minute.

    <p>False</p> Signup and view all the answers

    What does heart failure (HF) indicate?

    <p>Inadequate pumping and/or filling of the heart.</p> Signup and view all the answers

    Cardiac output can be calculated using the formula CO = SV x ______.

    <p>HR</p> Signup and view all the answers

    Match the components related to heart function with their definitions:

    <p>Cardiac Output = Amount of blood pumped by each ventricle in one minute Stroke Volume = Amount of blood ejected from the ventricle with each heartbeat Heart Failure = Inability of the heart to meet oxygen needs of tissues Perfusion = Process of delivering blood to the capillary bed</p> Signup and view all the answers

    Which of the following is a method to conduct a focused physical assessment?

    <p>Primary and secondary survey</p> Signup and view all the answers

    Clinical cues for patient deterioration include only vital sign changes.

    <p>False</p> Signup and view all the answers

    What impact does polypharmacy have on nursing care?

    <p>Increases the risk of drug interactions and complicates treatment plans.</p> Signup and view all the answers

    Which of the following are considered RAAS inhibitors?

    <p>ACE inhibitors</p> Signup and view all the answers

    Limiting sodium is recommended for patients with chronic heart failure.

    <p>True</p> Signup and view all the answers

    Name one positive inotropic agent used in heart failure treatment.

    <p>Digitalis</p> Signup and view all the answers

    Patients with heart failure should conserve their ______ to avoid fatigue.

    <p>energy</p> Signup and view all the answers

    What is the primary cause of heart failure?

    <p>Conditions that directly damage the heart</p> Signup and view all the answers

    Match the following symptoms with their corresponding management:

    <p>Fluid retention = Diuretics Increased heart rate = Beta-adrenergic blockers Shortness of breath = Activity/rest management High blood pressure = Vasodilators</p> Signup and view all the answers

    Which medication category includes Nitrates?

    <p>Vasodilators</p> Signup and view all the answers

    Right-sided heart failure is most commonly caused by right ventricular dysfunction alone.

    <p>False</p> Signup and view all the answers

    What are the symptoms of left ventricular failure (LVF)?

    <p>Increased pulmonary venous pressure, dyspnoea, cough with frothy sputum, tachycardia, and hypotension or hypertension.</p> Signup and view all the answers

    Home health nurses play an insignificant role in managing chronic heart failure.

    <p>False</p> Signup and view all the answers

    _____ is the process through which the heart chambers enlarge due to increased workload.

    <p>Ventricular dilation</p> Signup and view all the answers

    What is the primary focus of dietary therapy for heart failure?

    <p>Limit sodium intake</p> Signup and view all the answers

    Match the type of heart failure with its description:

    <p>Systolic HF = Inability to pump blood effectively Diastolic HF = Inability for ventricles to relax and fill Left-sided HF = Blood backs up into left atrium and lungs Right-sided HF = Blood backs up into right atrium and venous circulation</p> Signup and view all the answers

    Heart failure may require the use of ______ management tools for symptom management.

    <p>self</p> Signup and view all the answers

    Which of the following can be used for monitoring chronic heart failure patients?

    <p>Telehealth systems</p> Signup and view all the answers

    Which of the following is a compensatory mechanism of heart failure?

    <p>Ventricular hypertrophy</p> Signup and view all the answers

    Diastolic heart failure primarily results in the heart's inability to pump blood effectively.

    <p>False</p> Signup and view all the answers

    What is the significance of a sudden weight gain of more than 1.4 kg in two days in a patient with chronic heart failure?

    <p>It may indicate an exacerbation of chronic heart failure (ADHF).</p> Signup and view all the answers

    Heart failure often results in ________ cardiac output, which can lead to low blood pressure.

    <p>reduced</p> Signup and view all the answers

    Match the clinical manifestations with their related causes in heart failure:

    <p>Jugular venous distension = Right-sided HF Pulmonary congestion = Left-sided HF Cool, clammy skin = Left ventricular failure Hepatomegaly = Right-sided HF</p> Signup and view all the answers

    Study Notes

    Cardiac Output (CO)

    • Amount of blood pumped by each ventricle every minute
    • Normal range is 4 to 8 Liters per minute
    • Calculated by multiplying stroke volume (SV) and heart rate (HR)

    Stroke Volume (SV)

    • Amount of blood ejected from the ventricle with each heartbeat

    Heart Failure (HF)

    • Abnormal clinical syndrome characterized by inadequate heart pumping and/or filling
    • Leads to the heart's inability to supply sufficient blood for tissue oxygen needs
    • Can be acute or chronic
    • Risk factors
      • Primary causes: Conditions that directly damage the heart
      • Precipitating causes: Increase the workload of the ventricles
    • Results in a reduction of Cardiac Output (CO)

    Pathophysiology of HF

    • Systolic HF: Inability to pump blood effectively
    • Diastolic HF: Inability of the ventricle to relax and fill
    • Left, Right, or Biventricular HF: All result in reduced CO, leading to low BP and poor renal perfusion

    Compensatory Mechanisms in HF

    • Sympathetic nervous system: Attempts to increase heart rate and contractility
    • Neurohormonal responses (RAAS activation): Leads to vasoconstriction and fluid retention
    • Ventricular dilation: Enlargement of heart chambers to increase volume
    • Ventricular hypertrophy: Thickening of ventricle walls to increase contractility
    • These mechanisms result in ventricular remodeling, altering the heart's structure and function

    Acute Decompensated Heart Failure (ADHF) - Signs and Symptoms

    • Left Ventricular Failure (LVF): Increased pulmonary venous pressure leads to interstitial oedema and alveolar oedema
      • Manifestations:
        • Anxiety, pallor, cyanosis
        • Cool, clammy skin
        • Dyspnoea, orthopnoea, tachypnoea
        • Use of accessory muscles
        • Cough with frothy, blood-tinged sputum
        • Crackles, wheezes, rhonchi
        • Tachycardia
        • Hypotension or hypertension

    Left-sided Heart Failure

    • Most common form
    • Caused by left ventricular dysfunction
    • Backflow of blood into the left atrium and pulmonary veins
    • Increased pulmonary pressure leads to fluid leakage, causing pulmonary congestion and oedema

    Right-sided Heart Failure

    • Characterized by right ventricular dysfunction
    • Blood backs up into the right atrium and venous circulation
    • Manifestations:
      • Jugular venous distension
      • Hepatomegaly, splenomegaly
      • Vascular congestion of the gastrointestinal tract
      • Peripheral oedema
    • Commonly caused by left-sided heart failure
    • Other causes: Right ventricular infarction and pulmonary embolism

    Nursing Assessment - HF

    • Subjective:
      • Past medical history
      • Medications
      • Functional health patterns
    • Objective:
      • Priority cardiovascular and respiratory system assessment
      • Full body systems assessment

    Chronic Heart Failure - Clinical Manifestations

    • Fatigue, dyspnoea (orthopnoea, paroxysmal nocturnal dyspnoea, cough)
    • Tachycardia, oedema, weight changes (sudden weight gain > 1.4 kg in 2 days may indicate ADHF exacerbation)
    • Nocturia, skin changes, behavioral changes, limited activity, chest pain

    Diagnosing Heart Failure

    • Goal: Identify and treat the underlying cause
    • Strategies:
      • History and physical examination
      • Endomyocardial biopsy
      • Echocardiography (Ejection fraction %)
      • Chest X-ray
      • ECG, stress testing
      • Cardiac catheterization
      • Laboratory studies
      • ABGs

    Interprofessional Care - Chronic HF

    • Oxygen therapy
    • Medication therapy:
      • RAAS inhibitors (ACE inhibitors, angiotensin II receptor blockers)
      • Aldosterone antagonists
      • Beta-adrenergic blockers
      • Vasodilators (Nitrates, hydralazine)
      • Diuretics
      • Positive inotropic agents (digitalis - be alert for toxicity)
    • Physical and emotional rest
    • Structured exercise program
    • Low-sodium diet
    • Fluid restriction (if required) - <2L per day
    • Daily weights

    Chronic Heart Failure - Health Promotion

    • Basic principles of care:
      • Use of self-management tools for symptom management
      • Dietary restrictions (salt and water)
      • Energy conservation

    Heart Failure Treatment - Early Stages

    • Medications are the cornerstone of treatment
    • Lifestyle modifications: Lifestyle changes (diet, exercise, etc.)
    • Goal: Slow disease progression and improve quality of life
    • Potential complications:
      • Left ventricular dysfunction
      • Pulmonary congestion
      • Right-sided heart failure

    Patient Teaching - Chronic Heart Failure

    • Focus: Management of symptoms and early identification of exacerbations
    • Educate on:
      • Signs and symptoms of HF exacerbations
      • Medication therapy
      • Dietary therapy (sodium restriction)
      • Activity and rest
    • Home health nurse: Essential for ongoing support
    • Electronic or telehealth monitoring: May be beneficial

    Valvular Heart Disease (VHD)

    • Characterized by abnormalities in the heart valves
    • Types of heart valves:
      • Atrioventricular valves: Mitral and tricuspid valves
      • Semilunar valves: Aortic and pulmonary valves
    • Valvular function: Ensure unidirectional blood flow

    Valve Disorders

    • Stenosis (constriction): Narrowing of the valve, impeding forward blood flow
    • Regurgitation (incompetence/insufficiency): Incomplete closure of valve leaflets, resulting in backward blood flow
    • Common in older adults: Aortic stenosis (AS) and mitral regurgitation (MR)

    Nursing Assessment - Valvular Disorders

    • Focus:
      • Past health history
      • Clinical manifestations (differ according to valve and disorder)
      • Palpitations, weakness, activity intolerance, dizziness, fainting
      • Cough, haemoptysis, orthopnoea
      • Angina or atypical chest pain
      • Heart murmur
    • Refer to Chapter 35, Lewis's Medical Surgical Nursing text

    Diagnostic Studies - Valvular Heart Disease

    • Patient history and physical examination
    • Echocardiogram: Evaluates valve structure and function
    • CT scan of chest
    • Chest X-ray
    • ECG
    • Cardiac catheterization

    Interprofessional Care - Valvular Heart Disease

    • Conservative management:
      • Medications to treat/control heart failure
      • Anticoagulation therapy
      • Antiarrhythmia medications
      • Percutaneous transluminal balloon valvuloplasty (PTBV)
    • Surgical therapy:
      • Valve repair
      • Valve Replacement

    Sudden Cardiac Death (SCD)

    • Unexpected death from cardiac cause within 1 hour of symptom onset
    • Importance of early recognition and immediate response

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    Related Documents

    Heart Failure Nursing Management PDF

    Description

    This quiz explores key concepts related to cardiac output and heart failure. Learn about the definitions, normal ranges, and pathophysiology of heart failure conditions, including systolic and diastolic types. Understand the compensatory mechanisms involved and their impacts on cardiac function.

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