NURS 472: Heart Failure Care Quiz

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Questions and Answers

What is a key characteristic of acute heart failure?

It requires immediate or emergency intervention. (correct)

It can occur without any noticeable symptoms.

It develops over months to years.

It typically shows improvement with baseline symptoms.

Which of the following heart failure classifications occurs over months to years?

Right-sided heart failure

Acute decompensated heart failure

Chronic heart failure (correct)

Acute heart failure

What does HFrEF stand for in relation to left-sided heart failure?

Heart Failure with reduced ejection fraction (correct)

Heart Failure with restorative ejection fraction

High frequency reduced ejection failure

Heart Failure with relative ejection fraction

Which of the following symptoms is NOT typically associated with heart failure?

Nausea and vomiting Signup and view all the answers

In the NYHA Functional Classification, which class represents no limitations on physical activity?

Class I Signup and view all the answers

What is a significant risk factor for developing heart failure?

Hypertension (HTN) Signup and view all the answers

Which of the following conditions can lead to acute decompensated heart failure (ADHF)?

Emergence of acute stressors Signup and view all the answers

Which medication class can potentially worsen heart failure symptoms by decreasing ejection fraction?

Calcium channel blockers (CCB) Signup and view all the answers

What does an elevation in BNP indicate in patients with heart failure?

Elevated pulmonary artery occlusion pressure (PAOP) Signup and view all the answers

Which lab value should be monitored closely to assess the effects of diuresis?

Sodium level Signup and view all the answers

What is a common result of excessive volume removal in patients with heart failure?

Decreased preload Signup and view all the answers

Which diagnostic tool is primarily used to assess for dysrhythmias in heart failure patients?

Electrocardiogram (ECG) Signup and view all the answers

What is the primary purpose of using IV diuretics in the management of acute heart failure?

To reduce pulmonary edema Signup and view all the answers

Which of the following are inotropes used for in heart failure management?

Drugs that increase contractility Signup and view all the answers

What does the initial assessment of circulation in heart failure management aim to determine?

Adequacy of perfusion to organ systems Signup and view all the answers

Which statement regarding the use of mechanical support for acute decompensation of heart failure is accurate?

Intra-aortic balloon pumps can temporarily improve cardiac output. Signup and view all the answers

Study Notes

Heart Failure Overview

Heart Failure (HF) is a clinical syndrome resulting from structural/functional impairment of the ventricle, affecting its ability to pump or fill blood effectively.
High prevalence and mortality rates in the U.S.
Major risk factors include hypertension, diabetes mellitus, and atherosclerosis.

Heart Failure Classifications

Acute vs. Chronic HF
- Acute HF has rapid onset within days to hours; requires immediate intervention.
- Chronic HF develops over months to years; patients manage with baseline symptoms and can have periods of compensation.
- Acute decompensated HF (ADHF) can occur in chronic HF patients.
Left vs. Right HF
- Left-sided HF: inability of the left ventricle to fill/empty, categorized as:
 - HFrEF (Heart Failure with Reduced Ejection Fraction): EF < 40%
 - HFpEF (Heart Failure with Preserved Ejection Fraction): EF > 50%
- Right-sided HF: failure of the right ventricle to pump effectively.
Functional Classification
- New York Heart Association (NYHA) Class I-IV indicates symptom limitation from no limitations to symptoms at rest.
- American College of Cardiology/American Heart Association (ACC/AHA) stages A-D provide a framework for HF progression.

Causes of Heart Failure

Increased overall demand and structural abnormalities in coronary vessels, myocardium, or cardiac valves.
Common causes include ischemic heart disease, myocardial infarction, and valvular heart disease.

Assessment of Patients with Heart Failure

History Taking
- Symptoms may include orthopnea, dyspnea on exertion (DOE), paroxysmal nocturnal dyspnea (PND), dizziness, chest pain.
- Co-morbidities often involve atherosclerosis, diabetes, hypertension, coronary artery disease, and chronic obstructive pulmonary disease.
- Medications affecting myocardial function (e.g., calcium channel blockers) should be reviewed.
- Consider psychosocial factors such as cognitive decline and substance abuse.
Physical Examination
- Patients often appear ill; vital signs may vary.
- Cardiovascular exam may reveal signs of edema, typically bilateral and pitting.
Laboratory Tests
- Complete Blood Count (CBC), iron studies, thyroid function tests, electrolytes (monitor potassium), and renal function (BUN/creatinine).
- Elevated B-type Natriuretic Peptide (BNP) indicates increased pulmonary capillary occlusion pressure.
Diagnostic Tools
- Electrocardiogram (ECG) for dysrhythmias and ischemia.
- Echocardiogram (TTE or TEE) for structural assessment.
- Chest X-ray (CXR) for fluid status and heart size.
- Other tests may include Multigated Acquisition Scintigraphy (MUGA) and exercise testing.

Management of Acute Decompensation of Heart Failure (ADHF)

Primary Assessment
- Focus on Airway, Breathing, and Circulation - critical for managing ADHF.
Airway and Breathing Management
- Initiate IV diuretics for rapid diuresis to alleviate pulmonary edema.
- Monitor weight, intake/output, and electrolytes during diuretic therapy.
- Use adjunctive medications like tolvaptan.
Circulation Evaluation
- Assess perfusion adequacy to vital organs (e.g., brain, kidneys, GI tract).
Preload Adjustment
- Decreased preload often results from excessive volume removal via diuretics.
Inotropic Support
- Use inotropes to enhance myocardial contractility; drug choice based on patient condition.
Mechanical Support Options
- Intra-aortic Balloon Pump (IABP) for temporary support to improve cardiac output.
- Ventricular Assist Devices (VADs) provide ongoing circulatory support.

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Description

Test your knowledge on the care of patients with heart failure and mechanical assist devices in NURS 472 at Xavier University. This quiz covers key concepts, risk factors, and classifications of heart failure essential for nursing practice.