Podcast
Questions and Answers
Which of the following valves is NOT associated with unidirectional blood flow in the heart?
Which of the following valves is NOT associated with unidirectional blood flow in the heart?
Aortic stenosis is a type of valve regurgitation.
Aortic stenosis is a type of valve regurgitation.
False
Name two common clinical manifestations of valve disorders.
Name two common clinical manifestations of valve disorders.
Palpitations, weakness
The ___________ test is commonly used to diagnose valvular heart disease.
The ___________ test is commonly used to diagnose valvular heart disease.
Signup and view all the answers
Match the following terms with their definitions:
Match the following terms with their definitions:
Signup and view all the answers
What is the normal range for cardiac output (CO)?
What is the normal range for cardiac output (CO)?
Signup and view all the answers
Stroke volume (SV) is the amount of blood pumped by the heart in one minute.
Stroke volume (SV) is the amount of blood pumped by the heart in one minute.
Signup and view all the answers
What does heart failure (HF) indicate?
What does heart failure (HF) indicate?
Signup and view all the answers
Cardiac output can be calculated using the formula CO = SV x ______.
Cardiac output can be calculated using the formula CO = SV x ______.
Signup and view all the answers
Match the components related to heart function with their definitions:
Match the components related to heart function with their definitions:
Signup and view all the answers
Which of the following is a method to conduct a focused physical assessment?
Which of the following is a method to conduct a focused physical assessment?
Signup and view all the answers
Clinical cues for patient deterioration include only vital sign changes.
Clinical cues for patient deterioration include only vital sign changes.
Signup and view all the answers
What impact does polypharmacy have on nursing care?
What impact does polypharmacy have on nursing care?
Signup and view all the answers
Which of the following are considered RAAS inhibitors?
Which of the following are considered RAAS inhibitors?
Signup and view all the answers
Limiting sodium is recommended for patients with chronic heart failure.
Limiting sodium is recommended for patients with chronic heart failure.
Signup and view all the answers
Name one positive inotropic agent used in heart failure treatment.
Name one positive inotropic agent used in heart failure treatment.
Signup and view all the answers
Patients with heart failure should conserve their ______ to avoid fatigue.
Patients with heart failure should conserve their ______ to avoid fatigue.
Signup and view all the answers
What is the primary cause of heart failure?
What is the primary cause of heart failure?
Signup and view all the answers
Match the following symptoms with their corresponding management:
Match the following symptoms with their corresponding management:
Signup and view all the answers
Which medication category includes Nitrates?
Which medication category includes Nitrates?
Signup and view all the answers
Right-sided heart failure is most commonly caused by right ventricular dysfunction alone.
Right-sided heart failure is most commonly caused by right ventricular dysfunction alone.
Signup and view all the answers
What are the symptoms of left ventricular failure (LVF)?
What are the symptoms of left ventricular failure (LVF)?
Signup and view all the answers
Home health nurses play an insignificant role in managing chronic heart failure.
Home health nurses play an insignificant role in managing chronic heart failure.
Signup and view all the answers
_____ is the process through which the heart chambers enlarge due to increased workload.
_____ is the process through which the heart chambers enlarge due to increased workload.
Signup and view all the answers
What is the primary focus of dietary therapy for heart failure?
What is the primary focus of dietary therapy for heart failure?
Signup and view all the answers
Match the type of heart failure with its description:
Match the type of heart failure with its description:
Signup and view all the answers
Heart failure may require the use of ______ management tools for symptom management.
Heart failure may require the use of ______ management tools for symptom management.
Signup and view all the answers
Which of the following can be used for monitoring chronic heart failure patients?
Which of the following can be used for monitoring chronic heart failure patients?
Signup and view all the answers
Which of the following is a compensatory mechanism of heart failure?
Which of the following is a compensatory mechanism of heart failure?
Signup and view all the answers
Diastolic heart failure primarily results in the heart's inability to pump blood effectively.
Diastolic heart failure primarily results in the heart's inability to pump blood effectively.
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?
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?
Signup and view all the answers
Heart failure often results in ________ cardiac output, which can lead to low blood pressure.
Heart failure often results in ________ cardiac output, which can lead to low blood pressure.
Signup and view all the answers
Match the clinical manifestations with their related causes in heart failure:
Match the clinical manifestations with their related causes in heart failure:
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
- Manifestations:
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
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
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.