Heart Failure Management Overview
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Questions and Answers

What is a concerning weight change that should prompt monitoring for fluid retention?

  • ≥1 kg/week
  • ≥5 kg/week
  • ≥0.5 kg/week
  • ≥2.3 kg/week (correct)

    • Which symptom is NOT associated with pulmonary edema?

  • Chest pain (correct)
  • Restlessness
  • Cyanosis
  • Dyspnea

    • What is the recommended management step for suspected thromboembolism?

  • Administer vasodilators
  • Monitor heart rates
  • Use anticoagulants (correct)
  • Provide oxygen therapy

    • Which nursing diagnosis is related to the patient's lack of knowledge regarding their condition?

    <p>Noncompliance (A)</p> Signup and view all the answers

    Which intervention is NOT appropriate for managing anxiety due to breathlessness?

    <p>Ignore the patient's concerns (D)</p> Signup and view all the answers

    What is a common symptom of mitral regurgitation?

    <p>Palpitations (B)</p> Signup and view all the answers

    Which of the following is NOT a management option for aortic stenosis?

    <p>Anticoagulants (B)</p> Signup and view all the answers

    In the case of cardiac arrest, what is the immediate response required?

    <p>Perform CPR (C)</p> Signup and view all the answers

    What symptom would be expected in a patient with mitral stenosis?

    <p>Fatigue (A)</p> Signup and view all the answers

    Which assessment finding is associated with fluid overload?

    <p>JVD (jugular vein distention) (D)</p> Signup and view all the answers

    What is the primary definition of heart failure (HF)?

    <p>Inability of the heart to pump sufficient blood to meet the body's needs (A)</p> Signup and view all the answers

    Which type of heart failure is indicated by a low ejection fraction?

    <p>Low EF (Systolic HF) (D)</p> Signup and view all the answers

    Which of the following is NOT a clinical manifestation of left-sided heart failure?

    <p>Peripheral edema (D)</p> Signup and view all the answers

    What is a common etiology for heart failure?

    <p>Hypertension conditions (A)</p> Signup and view all the answers

    Which diagnostic test is key for measuring ejection fraction?

    <p>Echocardiography (C)</p> Signup and view all the answers

    Which medication is commonly used to improve cardiac function by reducing heart rate and workload?

    <p>Beta-Blockers (D)</p> Signup and view all the answers

    What component of lifestyle modification is recommended for heart failure patients?

    <p>Decrease fluid intake (D)</p> Signup and view all the answers

    What is the therapeutic level for Digoxin, which must be monitored to prevent toxicity?

    <p>0.5–2.0 ng/mL (A)</p> Signup and view all the answers

    Which of the following is a common symptom of right-sided heart failure?

    <p>Jugular venous distension (JVD) (B)</p> Signup and view all the answers

    Which component is crucial for the medical management of heart failure?

    <p>Delay progression and extend life expectancy (D)</p> Signup and view all the answers

    Flashcards

    Heart Failure (HF)

    Inability of the heart to pump enough blood to meet the body's needs for oxygen and nutrients.

    Ejection Fraction (EF)

    Percentage of blood pumped out of the ventricles during systole.

    Low EF Heart Failure

    Weakened heart ventricles have trouble pumping blood effectively.

    Normal EF Heart Failure (Diastolic)

    Thickened ventricles struggle to fill during diastole.

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    Left-sided Heart Failure

    Causes pulmonary symptoms (fluid buildup in the lungs).

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    Right-sided Heart Failure

    Causes systemic symptoms (fluid buildup in the body).

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    Coronary Artery Disease

    Blockage in the heart's blood vessels.

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    Echocardiography

    Ultrasound technique to view the heart's structure and function.

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    BNP

    Blood test measuring a protein released by the heart in response to strain.

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    Low Sodium Diet

    Restricting sodium intake to manage fluid retention in heart failure.

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    Fluid Overload Symptoms

    Symptoms like increased weight (≥2.3kg/week), crackles in the lungs, trouble breathing (orthopnea, dyspnea), and dry skin.

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    Activity Intolerance

    Inability to perform normal daily activities due to low heart function.

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    Pulmonary Edema Symptoms

    Anxiety, difficulty breathing, blue skin (cyanosis), and distended neck veins.

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    Pulmonary Edema Management

    Treat with oxygen, diuretics, and possibly vasodilators.

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    Mitral Regurgitation Symptoms

    Fatigue, shortness of breath, and a fast heartbeat.

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    Mitral Stenosis Symptoms

    Shortness of breath, fatigue, and trouble breathing while lying down.

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    Aortic Stenosis Symptoms

    Chest pain, fainting, and shortness of breath with activity.

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    Thromboembolism Prevention

    Use blood thinners to stop clots from forming or traveling.

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    Excess Fluid Volume

    Too much fluid in the body, causing swelling.

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    Cardiac Arrest Treatment

    Immediate CPR and advanced life support.

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    Study Notes

    Heart Failure (HF) Management

    • Definition: Inability of the heart to pump enough blood to meet the body's oxygen and nutrient needs.
    • Ejection Fraction (EF): Percentage of blood pumped out of ventricles during systole. Crucial in classifying HF types.
    • Types:
      • Low EF (Systolic HF): Weakened ventricles struggle to pump effectively.
      • Normal EF (Diastolic HF): Stiff ventricles fail to fill adequately during diastole.
      • Left-sided HF: Primarily pulmonary symptoms (dyspnea, orthopnea) due to congested lungs.
      • Right-sided HF: Primarily systemic symptoms (peripheral edema, JVD) due to fluid backup.

    Etiology (Causes)

    • Coronary artery disease (atherosclerosis)
    • Systemic or pulmonary hypertension
    • Valvular disorders (mitral stenosis or regurgitation)
    • Diabetes mellitus
    • Cardiomyopathy

    Clinical Manifestations

    • Left-sided HF: Dyspnea, orthopnea, pulmonary crackles, paroxysmal nocturnal dyspnea.
    • Right-sided HF: JVD, peripheral edema, hepatomegaly, ascites.

    Assessment and Diagnosis

    • Comprehensive history and physical exam
    • Echocardiography: Essential for EF measurement.
    • Chest X-ray: Shows pulmonary congestion.
    • BNP: Elevated levels indicate HF severity.
    • Electrolytes, CBC, ECG: Supporting diagnostic evaluation.

    Medical Management

    • Goal: Improve cardiac function, reduce symptoms/hospitalizations, delay disease progression, and enhance quality of life.
    • Pharmacologic Therapy:
      • ACE inhibitors (captopril): Vasodilation, diuresis
      • ARBs (valsartan): Lower BP, improve cardiac output
      • Beta-blockers: Slow heart rate, reduce workload
      • Diuretics (furosemide): Increase urine output
      • Digoxin: Improves contractility (caution for toxicity; therapeutic range 0.5–2.0 ng/mL)
      • Anticoagulants: Prevent thromboembolism
      • Avoid NSAIDs for this condition.

    Lifestyle and Nutritional Modifications

    • Low-sodium diet (≤2 g/day): Essential for reduced fluid retention.
    • Restrict fluids, supplemental oxygen in cases of congestion.
    • Avoid excess alcohol, smoking.
    • Maintain a healthy weight and regular exercise.

    Nursing Management

    • Monitoring: Daily weights (monitor for excessive fluid gain), lung sounds, JVD, symptoms (orthopnea, dyspnea), skin turgor.
    • Interventions: Medication administration, psychological support.

    Nursing Diagnoses

    • Activity intolerance
    • Excess fluid volume
    • Anxiety
    • Noncompliance

    Complications and Management

    • Pulmonary Edema: Anxiety, restlessness, dyspnea, cyanosis, moist hands, distended neck veins. Immediate management includes supplemental oxygen, diuretics, and vasodilators.
    • Thromboembolism: Prophylactic anticoagulation is crucial.
    • Cardiac Arrest: Immediate CPR and advanced life support.

    Diseases of the Heart Valves

    • Mitral Regurgitation: Symptoms - Fatigue, dyspnea, palpitations. Management - ACE inhibitors, ARBs, surgery (valvuloplasty).
    • Mitral Stenosis: Symptoms - Dyspnea, fatigue, orthopnea. Management - Anticoagulants, surgery (commissurotomy).
    • Aortic Stenosis: Symptoms - Chest pain, syncope, exertional dyspnea. Management - Valve replacement or TAVI (transcatheter aortic valve implantation).

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    Description

    This quiz covers the management of heart failure, including definitions, ejection fractions, and types of heart failure. Explore the causes and clinical manifestations related to both left-sided and right-sided heart failure. Test your knowledge on this critical health topic.

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