Podcast
Questions and Answers
What is a recommended nonpharmacologic treatment for congestive heart failure (CHF)?
What is a recommended nonpharmacologic treatment for congestive heart failure (CHF)?
Which diagnostic test is specific for assessing heart failure?
Which diagnostic test is specific for assessing heart failure?
What is the significance of measuring the ejection fraction (EF) in heart failure?
What is the significance of measuring the ejection fraction (EF) in heart failure?
What does preload refer to in the context of heart function?
What does preload refer to in the context of heart function?
Signup and view all the answers
Which of the following lifestyle modifications is NOT suggested for managing CHF?
Which of the following lifestyle modifications is NOT suggested for managing CHF?
Signup and view all the answers
In the context of congestive heart failure, which statement about edema is correct?
In the context of congestive heart failure, which statement about edema is correct?
Signup and view all the answers
What condition describes the situation when blood backs up into the periphery, such as the liver and feet?
What condition describes the situation when blood backs up into the periphery, such as the liver and feet?
Signup and view all the answers
What is the primary consequence of increased afterload on the heart?
What is the primary consequence of increased afterload on the heart?
Signup and view all the answers
Which of the following is an outcome of fluid overload in congestive heart failure?
Which of the following is an outcome of fluid overload in congestive heart failure?
Signup and view all the answers
Hypertrophy of the cardiac muscle in congestive heart failure is primarily a response to what condition?
Hypertrophy of the cardiac muscle in congestive heart failure is primarily a response to what condition?
Signup and view all the answers
What is the primary physiological role of the left ventricle?
What is the primary physiological role of the left ventricle?
Signup and view all the answers
Which condition is NOT associated with fluid overload in heart failure?
Which condition is NOT associated with fluid overload in heart failure?
Signup and view all the answers
In congestive heart failure, which statement about the right atrium is correct?
In congestive heart failure, which statement about the right atrium is correct?
Signup and view all the answers
What condition is characterized by blood backing up in the lungs, causing breathing problems?
What condition is characterized by blood backing up in the lungs, causing breathing problems?
Signup and view all the answers
What happens to the ventricles during congestive heart failure?
What happens to the ventricles during congestive heart failure?
Signup and view all the answers
Which symptom is specifically associated with left-sided heart failure?
Which symptom is specifically associated with left-sided heart failure?
Signup and view all the answers
Which of the following indicates right-sided heart failure?
Which of the following indicates right-sided heart failure?
Signup and view all the answers
What is a common positioning symptom in heart failure that helps relieve breathing difficulties?
What is a common positioning symptom in heart failure that helps relieve breathing difficulties?
Signup and view all the answers
What does increased peripheral venous pressure indicate?
What does increased peripheral venous pressure indicate?
Signup and view all the answers
Which symptom is NOT typically associated with congestive heart failure?
Which symptom is NOT typically associated with congestive heart failure?
Signup and view all the answers
What does an increase in pulmonary capillary wedge pressure suggest?
What does an increase in pulmonary capillary wedge pressure suggest?
Signup and view all the answers
Study Notes
Congestive Heart Failure (CHF)
- Hypertrophy (muscle enlargement) is a feature of CHF
- Preload is pressure in the right atrium
- Afterload is resistance left ventricle faces to push oxygenated blood
- Right-sided CHF: fluid backs up in periphery (e.g., liver, feet)
- Left-sided CHF: fluid backs up in lungs causing dyspnea and pulmonary edema
- CHF symptoms include: fluid overload, dyspnea, pulmonary congestion, orthopnea, cyanosis, tripod positioning, peripheral venous pressure, ascites, enlarged liver/spleen, distended jugular veins, and weight gain/dependent edema
- Four stages of CHF
- Non-pharmacologic treatment includes limiting salt, alcohol, saturated fat, and encouraging exercise
- Diagnostic tests: BNP (<100) or echocardiogram (EF <50%)
- Digoxin (Lanoxin) is a cardiac glycoside that increases contractility, decreases heart rate, decreases conduction, and increases stroke volume
- Check heart rate before digoxin administration
- Diuretics interact with digoxin, leading to hypokalemia
- Digoxin toxicity symptoms: GI symptoms, bradycardia, visual disturbances (yellow halos)
- Digibind is the antidote for digoxin toxicity
- Milrinone (Primacor) is a phosphodiesterase inhibitor for short-term CHF
- Primacor is administered IV in ICU and has fatal ventricular dysrhythmias as potential adverse effects
- Nesiritide (Natrecor) is a natriuretic peptide for acute heart failure, common adverse effect is hypotension
- ACE inhibitors, diuretics and potassium are nephrotoxic, monitor BUN & creatinine
- Atherosclerosis is a cause of coronary artery disease & high lipid intake
- Lipid build-up from high dietary lipids is a major cause of coronary artery disease
- Treat CHF by unloading the patient quickly
Angina (Chest Pain)
- Angina is a major symptom of coronary artery disease
- Nitroglycerin is an antianginal drug. Adverse effects include hypotension and headache
- Nitroglycerin relaxes coronary arteries, a vasodilator
- Important to check blood pressure before administering Nitroglycerin
- Nitroglycerin should be taken via oral or topical route avoiding sunlight
- Atenolol is a beta blocker reducing oxygen need & anginal pain
- P wave = atrial activation; QRS = ventricular activation; T wave = recovery
- Class 3 antidysrhythmics like amiodarone & dronedarone prolong repolarization and are used to treat ventricular dysrhythmias
- Diltiazem treats atrial fibrillation
- Emergency drugs for cardiac disorders: MONA (Morphine, Oxygen, Nitroglycerin, Aspirin)
Respiratory Agents
- Three lobes in the right lung, two in the left due to the heart's presence
- Ventilation is the process of oxygen passing through the airways
- Perfusion is the blood flow to the alveolar capillaries
- Ventilation/perfusion ratio (V/Q ratio) is ideally equal
- Diffusion involves gas exchange between oxygen and carbon dioxide
- Common cold symptoms include sneezing, nasal congestion, cough, and sore throat; use nonpharmacologic remedies.
- Decongestants (e.g., pseudoephedrine or oxymetazoline) stimulate alpha-adrenergic receptors for nasal mucosa shrinkage. Adrenergic medications should be used with caution.
- Antihistamines treat allergic reactions, induce sleep, help with common cold symptoms, and treat motion sickness/Nausea
- Antihistamines block the histamine 1 receptor.
- Intranasal glucocorticoids are used to control inflammation, and can cause nasal dryness
- Obstructive pulmonary diseases: Emphysema, COPD, Asthma
- Restrictive pulmonary diseases: Fluid accumulation or elasticity loss, e.g., tumors or Scoliosis
- Chronic obstructive pulmonary disease (COPD) reduces airflow reversibly.
- Emphysema permanently enlarges alveoli and destroys alveolar walls.
- Chronic bronchitis involves mucus hypersecretion and continuous productive cough.
- Asthma involves airway inflammation, often related to allergens or irritants, causing constriction and increased mucus.
- Albuterol is a beta2-agonist bronchodilator used in acute attacks (rescue inhaler)
- Ipratropium bromide helps decrease bronchoconstriction and mucus secretion
- Xanthines such as theophylline enhance bronchodilation/decrease bronchospasm.
- Corticosteroids such as beclomethasone reduce inflammation in asthma or COPD.
- Leukotriene modifiers like montelukast reduce inflammatory symptoms of asthma
- Cromolyn prevents histamine release, used prophylactically in asthma
UTI Infections
- Acute pyelonephritis is a kidney infection (often E.coli in females). Symptoms include chills, fever, flank pain, urinary symptoms (dysuria, frequency, urgency).
- Acute cystitis is a bladder infection (often E.coli or other bacteria). Symptoms are similar to pyelonephritis, but without flank pain.
- Bactrim, Nitrofurantoin, Ciprofloxacin are antibiotics used to treat UTIs. Specific advice regarding individual drugs is provided in a separate study section.
Immunizations
- Active immunity involves the body's immune response to an antigen; creating its own antibodies (from vaccines).
- Passive immunity involves receiving pre-formed antibodies(via breastmilk, plasma transfusion, etc)
- Vaccination is an example of active immunity.
- Many vaccines are contraindicated during pregnancy.
- Influenza IM shots are acceptable during pregnancy
- Common bacterial illnesses, like smallpox and anthrax; some infections can be caused through bioterrorism
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers essential aspects of Congestive Heart Failure (CHF), including its symptoms, diagnostic tests, and treatment options. Understand the pathophysiology involving hypertrophy, preload, and afterload, as well as the differences between right-sided and left-sided heart failure. Test your knowledge on treatment strategies and key medications used in managing CHF.
