Heart Failure Insights from ATI Flashcards

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Questions and Answers

What is heart failure?

A simple disease

Only affects the left side of the heart

Complex clinical syndrome resulting in insufficient blood supply/oxygen to tissues and organs (correct)

A type of arrhythmia

What does decreased cardiac output lead to?

Decreased tissue perfusion

What is ejection fraction (EF)?

Amount of blood pumped out of the left ventricle with each systole

What characterizes heart failure with reduced ejection fraction (HFREF)?

Defect in ventricular systolic function or left ventricular contraction Signup and view all the answers

What characterizes heart failure with preserved ejection fraction (HFPEF)?

Defect in ventricular diastolic function or filling Signup and view all the answers

What is left-sided heart failure?

Most common form of heart failure, characterized by inability of left ventricle to empty or fill adequately Signup and view all the answers

What happens in right-sided heart failure?

Right ventricle does not pump effectively, fluid backs up in the venous system Signup and view all the answers

What does reduced ejection fraction indicate?

Inability to pump blood effectively due to impaired contractile function Signup and view all the answers

What causes preserved ejection fraction?

Inability of ventricles to relax and fill during diastole Signup and view all the answers

What is acute decompensated heart failure?

Sudden increase in symptoms of heart failure requiring rapid escalation of therapy Signup and view all the answers

What does the New York Heart Association's (NYHA) classification measure?

Severity of heart failure based on activity level that induces symptoms Signup and view all the answers

What is a risk factor for left-sided heart failure?

Hypertension Signup and view all the answers

What should be monitored in a client taking diuretics?

Vital signs and hemodynamic pressures Signup and view all the answers

What role do beta blockers play in heart failure management?

Improve the condition of clients by reducing sympathetic stimulation Signup and view all the answers

What is the primary function of inotropic agents?

Increase contractility and improve cardiac output Signup and view all the answers

What is the expected reference range for left ventricular ejection fraction?

55% to 70% Signup and view all the answers

What should be monitored while using Human B-type natriuretic peptides?

Blood pressure Signup and view all the answers

Name one anticoagulant that can be prescribed if the client has a history of thrombus formation.

Warfarin Signup and view all the answers

What should be assessed for contraindications when using anticoagulants?

All of the above Signup and view all the answers

What is a Ventricular Assist Device (VAD)?

A mechanical pump that assists a heart that is too weak to pump blood. Signup and view all the answers

Heart transplantation is the treatment of choice for clients with severe dilated cardiomyopathy.

True Signup and view all the answers

What are contraindications to VAD surgery?

Severe chronic lung disease, end-stage kidney disease, clotting disorders, infections unresponsive to antibiotic therapy. Signup and view all the answers

Match the following terms to their definitions:

Heart Transplantation = Immunosuppressant therapy is required post-transplantation. Acute Pulmonary Edema = A life-threatening medical emergency that requires prompt intervention. Ventricular Assist Device (VAD) = Mechanical pump that assists a weak heart. Anticoagulants = Medications that prevent blood clot formation. Signup and view all the answers

Clients with end-stage heart failure may require immunosuppressant therapy post-heart transplantation.

True Signup and view all the answers

What should heart transplantation clients do regarding fluid intake?

Restrict fluid and sodium as instructed. Signup and view all the answers

Which of the following are expected findings in acute pulmonary edema? (Select all that apply)

Change in level of consciousness Signup and view all the answers

What is an immediate nursing action in response to acute pulmonary edema?

Positioning the client in high-Fowler's position. Signup and view all the answers

Study Notes

Heart Failure Overview

Heart failure is a complex clinical syndrome leading to inadequate blood supply and oxygen to tissues.
Results in decreased cardiac output and tissue perfusion.

Types of Heart Failure

HFREF (Heart Failure with Reduced Ejection Fraction): Involves a defect in ventricular systolic function, indicating poor left ventricle (LV) contraction.
HFPEF (Heart Failure with Preserved Ejection Fraction): Involves a defect in ventricular diastolic function, affecting filling; primarily caused by hypertension.

Left vs Right Sided Heart Failure

Left Sided Heart Failure: Most common form; results in inability of LV to empty or fill adequately, causing blood to back up into the left atrium.
Right Sided Heart Failure: Ineffective RV pumping leads to fluid backing up into the venous system and tissues; often secondary to left-sided heart failure or conditions like RV infarction and pulmonary problems.

Acute Decompensated Heart Failure

Characterized by worsening symptoms requiring rapid escalation of therapy.
Early signs include increased pulmonary venous pressure and mild respiratory rate increase; later signs include interstitial and alveolar edema.

Heart Failure Classifications

NYHA functional classification ranges from Class I (no manifestations with activity) to Class IV (manifestations at rest) to gauge severity.
ACC/AHA stages categorize patients based on structural heart disease presence, ranging from high risk (Stage A) to refractory end-stage heart failure (Stage D).

Risk Factors

Left-sided failure: hypertension, coronary artery disease, valvular disease.
Right-sided failure: left-sided failure, RV infarction, pulmonary issues.
High-output failure linked to increased metabolic needs, infections, anemia, and hyperthyroidism.
Cardiomyopathy risk factors include coronary artery disease and prolonged alcohol use.

Expected Findings

Left-sided failure: Symptoms like dyspnea, orthopnea, pulmonary congestion, fatigue, and altered mental status.
Right-sided failure: Symptoms include jugular vein distention, peripheral edema, and ascites.

Cardiomyopathy

Four types: dilated (most common), hypertrophic, arrhythmogenic right ventricular, restrictive.
Manifestations include fatigue, heart failure signs, dysrhythmias, and cardiomegaly.

Laboratory Tests

Elevated Human B-type natriuretic peptides (hBNP) help diagnose heart failure versus respiratory issues; levels guide treatment intensity.
Hemodynamic monitoring typically shows increased pressures and decreased cardiac output.

Diagnostic Procedures

Echocardiograms assess heart function and ejection fractions.
Chest x-ray reveals cardiomegaly and fluid accumulation.

Nursing Care

Daily monitoring of weight and intake/output; assess for shortness of breath, administer oxygen as needed.
Educate clients about diet restrictions, particularly sodium and fluid intake.

Medications

Diuretics: Reduce preload; monitor for hypokalemia and administer potassium if needed.
Afterload-reducing agents: ACE inhibitors (enalapril), ARBs (losartan); important nursing considerations include monitoring blood pressure and potassium levels.
Inotropic agents: Increase contractility; monitor for signs of digoxin toxicity.
Beta Blockers: Useful for chronic heart failure; involve daily blood pressure monitoring and weight checks.
Vasodilators: Effective for controlling blood pressure; cause orthostatic hypotension.
Anticoagulants: Prescribed for clients with a history of thrombus; monitor bleeding times.

Advanced Therapies

Ventricular Assist Device (VAD): Supports severely compromised heart function; used while awaiting transplant.
Heart transplantation: Treatment of choice for severe dilated cardiomyopathy; requires postoperative immunosuppressant therapy.### Transplant Eligibility Factors
Transplant eligibility considers life expectancy, age, psychosocial status, and absence of substance use disorders.

Heart Transplantation Nursing Actions

Prepare client for the procedure: maintain NPO status and obtain informed consent.
Monitor vital signs, SaO2, incision drainage, and manage pain postoperatively.
Watch for complications such as infection, thrombosis, and organ rejection in transplant recipients.

Heart Transplantation Client Education

Take diuretics in the early morning and afternoon to manage fluid balance.
Follow fluid and sodium restriction as per medical instructions.
Regulate potassium intake to prevent imbalances.
Consult a dietitian for menu planning.
Weigh daily and notify the provider if weight gain exceeds 2 lbs in 24 hours or 5 lbs in a week.
Schedule regular follow-up visits with healthcare providers.
Obtain pneumococcal and yearly influenza vaccines to prevent infections.

Complications: Acute Pulmonary Edema

Acute pulmonary edema is a life-threatening emergency requiring immediate intervention.
Key interventions include diuresis to monitor fluid output, alleviate respiratory distress, improve lung sounds, and ensure adequate oxygenation.

Acute Pulmonary Edema Expected Findings

Symptoms include anxiety, tachycardia, acute respiratory distress, dyspnea at rest, altered consciousness, and ascending fluid levels in lungs evidenced by crackles and frothy, blood-tinged sputum.

Acute Pulmonary Edema Nursing Actions

Position client in high-Fowler's position to enhance breathing.
Administer oxygen and consider positive airway pressure, intubation, and mechanical ventilation as necessary.
Provide IV morphine to reduce anxiety and respirational distress, and decrease venous return.
Administer rapid-acting loop diuretics, such as furosemide, via IV for fluid management.
Give prescribed medications to improve cardiac output.
Educate clients on techniques to balance activity and rest to improve tolerance to daily activities.

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Description

This quiz covers essential concepts related to heart failure, as outlined in PowerPoint presentations and ATI flashcards. Test your understanding of definitions, implications of decreased cardiac output, and the importance of ejection fraction. Perfect for nursing students and those studying cardiovascular health.