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Questions and Answers
A patient with heart failure has an ejection fraction of 40%. Based on this information, which of the following statements is most accurate?
A patient with heart failure has an ejection fraction of 40%. Based on this information, which of the following statements is most accurate?
- The patient's heart is contracting too forcefully, causing damage to the ventricles.
- The patient's ejection fraction is within the normal range.
- The patient's heart is beating too slowly, requiring immediate intervention.
- The patient's ejection fraction is indicative of heart failure. (correct)
A patient with heart failure is being monitored for hemodynamic changes. Which set of readings would the nurse expect to see correlate with heart failure?
A patient with heart failure is being monitored for hemodynamic changes. Which set of readings would the nurse expect to see correlate with heart failure?
- Decreased CVP, increased PAWP
- Increased CVP, decreased PAWP
- Decreased CVP, decreased PAWP
- Increased CVP, increased PAWP (correct)
Which of the following medication classes works by reducing fluid volume to decrease the workload on the heart?
Which of the following medication classes works by reducing fluid volume to decrease the workload on the heart?
- Calcium Channel Blockers
- Anticoagulants
- Beta Blockers
- Diuretics (correct)
A nurse is caring for a patient with heart failure. Which intervention is most important for the nurse to implement to assess fluid balance?
A nurse is caring for a patient with heart failure. Which intervention is most important for the nurse to implement to assess fluid balance?
A patient with heart failure is prescribed digoxin. The nurse understands that the therapeutic effect of digoxin in heart failure is to:
A patient with heart failure is prescribed digoxin. The nurse understands that the therapeutic effect of digoxin in heart failure is to:
A patient's heart is unable to pump enough blood to meet the body's needs. Which condition is the patient experiencing?
A patient's heart is unable to pump enough blood to meet the body's needs. Which condition is the patient experiencing?
Which of the following pathological conditions can directly lead to decreased cardiac output and subsequently cause heart failure?
Which of the following pathological conditions can directly lead to decreased cardiac output and subsequently cause heart failure?
A patient presents with dyspnea and crackles in the lungs. Which type of heart failure is the most likely cause of these symptoms?
A patient presents with dyspnea and crackles in the lungs. Which type of heart failure is the most likely cause of these symptoms?
Which of the following assessment findings is most indicative of right-sided heart failure?
Which of the following assessment findings is most indicative of right-sided heart failure?
A patient with known heart failure has distended jugular veins, even when sitting upright. This clinical sign is most directly related to:
A patient with known heart failure has distended jugular veins, even when sitting upright. This clinical sign is most directly related to:
A patient's lab results show an elevated hBNP level of 150 pg/mL. This result suggests:
A patient's lab results show an elevated hBNP level of 150 pg/mL. This result suggests:
Which sequence accurately describes the flow of blood through the heart and to the rest of the body?
Which sequence accurately describes the flow of blood through the heart and to the rest of the body?
A patient with a history of hypertension is diagnosed with heart failure. Which of the following mechanisms explains how hypertension contributes to the development of heart failure?
A patient with a history of hypertension is diagnosed with heart failure. Which of the following mechanisms explains how hypertension contributes to the development of heart failure?
Flashcards
Heart Failure
Heart Failure
The heart cannot pump enough blood to meet the body's needs.
Heart Failure Pathophysiology
Heart Failure Pathophysiology
Congenital defects or disorders damage the heart, decreasing cardiac output.
Left-Sided Heart Failure
Left-Sided Heart Failure
Blood backs up into the lungs, causing pulmonary congestion.
Left-Sided Heart Failure Symptoms
Left-Sided Heart Failure Symptoms
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Right-Sided Heart Failure
Right-Sided Heart Failure
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Right-Sided Heart Failure Symptoms
Right-Sided Heart Failure Symptoms
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Heart Failure Diagnostics
Heart Failure Diagnostics
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hBNP
hBNP
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Echocardiogram
Echocardiogram
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Ejection Fraction (EF)
Ejection Fraction (EF)
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Hemodynamic Monitoring
Hemodynamic Monitoring
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Diuretics
Diuretics
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High Fowler's Position
High Fowler's Position
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Study Notes
- Heart failure arises when the heart muscle cannot pump enough blood to meet the body's needs
Pathophysiology
- Heart failure is caused by congenital heart defects/disorders that damage or overwork the heart
- These include coronary heart disease, cardiomyopathy, hypertension, or valvular disease
- These disorders decrease cardiac output
Signs and Symptoms
- Signs and symptoms differ based on whether it's left- or right-sided heart failure
- Blood flows into the right side of the heart, then to the lungs, then the left side, then out to the body
Left-Sided Heart Failure
- Occurs when blood backs up into the lungs, resulting in pulmonary congestion
- Symptoms include dyspnea (shortness of breath)
- Crackles in the lungs
- Fatigue
- Frothy sputum
Right-Sided Heart Failure
- Occurs when blood backs up from the right side of the heart into the body, causing systemic congestion
- Symptoms include peripheral edema (swelling)
- Ascites (fluid accumulation in the abdomen)
- Jugular vein distension
- Hepatomegaly (enlargement of the liver)
Labs and Diagnostics
- Diagnostic tools include labs, screening procedures, echocardiograms, and hemodynamic monitoring
Labs
- Measuring hBNP level can diagnose heart failure
- hBNP is released by the heart in response to stretching due to blood backup
- hBNP level over 100 pg/mL is indicative of heart failure
Diagnostic Tools
- Echocardiograms measure ejection fraction
- Ejection fraction is the percentage of blood leaving the ventricle with each contraction
- Normal left ventricular ejection fraction is between 55-70%
- Ejection fraction under 55% indicates heart failure
- Hemodynamic monitoring reveals increased central venous pressure (CVP)
- Hemodynamic monitoring also reveals increased pulmonary artery wedge pressure (PAWP)
Treatment
- Diuretics help remove excess fluid to decrease the heart's workload
- Digoxin helps the heart beat more efficiently with stronger, slower contractions
- Other medications include antihypertensive agents like beta blockers
- Also ACE inhibitors, calcium channel blockers, and angiotensin II blockers
- Vasodilators and anticoagulants are also used
Nursing Care
- Track the patient's weight daily
- Monitor intake and output
- Sit the patient upright in high Fowler’s position to ease breathing
- Administer oxygen
- Restrict fluid and sodium intake as ordered
- Monitor for complications, including pulmonary edema (excess fluid in the lungs)
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